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Sample records for model representing clinical

  1. A model-driven approach for representing clinical archetypes for Semantic Web environments.

    Science.gov (United States)

    Martínez-Costa, Catalina; Menárguez-Tortosa, Marcos; Fernández-Breis, Jesualdo Tomás; Maldonado, José Alberto

    2009-02-01

    The life-long clinical information of any person supported by electronic means configures his Electronic Health Record (EHR). This information is usually distributed among several independent and heterogeneous systems that may be syntactically or semantically incompatible. There are currently different standards for representing and exchanging EHR information among different systems. In advanced EHR approaches, clinical information is represented by means of archetypes. Most of these approaches use the Archetype Definition Language (ADL) to specify archetypes. However, ADL has some drawbacks when attempting to perform semantic activities in Semantic Web environments. In this work, Semantic Web technologies are used to specify clinical archetypes for advanced EHR architectures. The advantages of using the Ontology Web Language (OWL) instead of ADL are described and discussed in this work. Moreover, a solution combining Semantic Web and Model-driven Engineering technologies is proposed to transform ADL into OWL for the CEN EN13606 EHR architecture.

  2. Detailed clinical models: representing knowledge, data and semantics in healthcare information technology.

    Science.gov (United States)

    Goossen, William T F

    2014-07-01

    This paper will present an overview of the developmental effort in harmonizing clinical knowledge modeling using the Detailed Clinical Models (DCMs), and will explain how it can contribute to the preservation of Electronic Health Records (EHR) data. Clinical knowledge modeling is vital for the management and preservation of EHR and data. Such modeling provides common data elements and terminology binding with the intention of capturing and managing clinical information over time and location independent from technology. Any EHR data exchange without an agreed clinical knowledge modeling will potentially result in loss of information. Many attempts exist from the past to model clinical knowledge for the benefits of semantic interoperability using standardized data representation and common terminologies. The objective of each project is similar with respect to consistent representation of clinical data, using standardized terminologies, and an overall logical approach. However, the conceptual, logical, and the technical expressions are quite different in one clinical knowledge modeling approach versus another. There currently are synergies under the Clinical Information Modeling Initiative (CIMI) in order to create a harmonized reference model for clinical knowledge models. The goal for the CIMI is to create a reference model and formalisms based on for instance the DCM (ISO/TS 13972), among other work. A global repository of DCMs may potentially be established in the future.

  3. Representing uncertainty on model analysis plots

    Directory of Open Access Journals (Sweden)

    Trevor I. Smith

    2016-09-01

    Full Text Available Model analysis provides a mechanism for representing student learning as measured by standard multiple-choice surveys. The model plot contains information regarding both how likely students in a particular class are to choose the correct answer and how likely they are to choose an answer consistent with a well-documented conceptual model. Unfortunately, Bao’s original presentation of the model plot did not include a way to represent uncertainty in these measurements. I present details of a method to add error bars to model plots by expanding the work of Sommer and Lindell. I also provide a template for generating model plots with error bars.

  4. Representing Uncertainty on Model Analysis Plots

    Science.gov (United States)

    Smith, Trevor I.

    2016-01-01

    Model analysis provides a mechanism for representing student learning as measured by standard multiple-choice surveys. The model plot contains information regarding both how likely students in a particular class are to choose the correct answer and how likely they are to choose an answer consistent with a well-documented conceptual model.…

  5. Identifying optimal models to represent biochemical systems.

    Directory of Open Access Journals (Sweden)

    Mochamad Apri

    Full Text Available Biochemical systems involving a high number of components with intricate interactions often lead to complex models containing a large number of parameters. Although a large model could describe in detail the mechanisms that underlie the system, its very large size may hinder us in understanding the key elements of the system. Also in terms of parameter identification, large models are often problematic. Therefore, a reduced model may be preferred to represent the system. Yet, in order to efficaciously replace the large model, the reduced model should have the same ability as the large model to produce reliable predictions for a broad set of testable experimental conditions. We present a novel method to extract an "optimal" reduced model from a large model to represent biochemical systems by combining a reduction method and a model discrimination method. The former assures that the reduced model contains only those components that are important to produce the dynamics observed in given experiments, whereas the latter ensures that the reduced model gives a good prediction for any feasible experimental conditions that are relevant to answer questions at hand. These two techniques are applied iteratively. The method reveals the biological core of a model mathematically, indicating the processes that are likely to be responsible for certain behavior. We demonstrate the algorithm on two realistic model examples. We show that in both cases the core is substantially smaller than the full model.

  6. STATISTICAL MODELS OF REPRESENTING INTELLECTUAL CAPITAL

    Directory of Open Access Journals (Sweden)

    Andreea Feraru

    2016-06-01

    Full Text Available This article entitled Statistical Models of Representing Intellectual Capital approaches and analyses the concept of intellectual capital, as well as the main models which can support enterprisers/managers in evaluating and quantifying the advantages of intellectual capital. Most authors examine intellectual capital from a static perspective and focus on the development of its various evaluation models. In this chapter we surveyed the classical static models: Sveiby, Edvisson, Balanced Scorecard, as well as the canonical model of intellectual capital. Among the group of static models for evaluating organisational intellectual capital the canonical model stands out. This model enables the structuring of organisational intellectual capital in: human capital, structural capital and relational capital. Although the model is widely spread, it is a static one and can thus create a series of errors in the process of evaluation, because all the three entities mentioned above are not independent from the viewpoint of their contents, as any logic of structuring complex entities requires.

  7. Assessing Use of Cognitive Heuristic Representativeness in Clinical Reasoning

    OpenAIRE

    Payne, Velma L.; Crowley, Rebecca S.

    2008-01-01

    We performed a pilot study to investigate use of the cognitive heuristic Representativeness in clinical reasoning. We tested a set of tasks and assessments to determine whether subjects used the heuristics in reasoning, to obtain initial frequencies of heuristic use and related cognitive errors, and to collect cognitive process data using think-aloud techniques. The study investigates two aspects of the Representativeness heuristic - judging by perceived frequency and representativeness as ca...

  8. Picturing and modelling catchments by representative hillslopes

    Science.gov (United States)

    Loritz, Ralf; Hassler, Sibylle; Jackisch, Conrad; Zehe, Erwin

    2016-04-01

    Hydrological modelling studies often start with a qualitative sketch of the hydrological processes of a catchment. These so-called perceptual models are often pictured as hillslopes and are generalizations displaying only the dominant and relevant processes of a catchment or hillslope. The problem with these models is that they are prone to become too much predetermined by the designer's background and experience. Moreover it is difficult to know if that picture is correct and contains enough complexity to represent the system under study. Nevertheless, because of their qualitative form, perceptual models are easy to understand and can be an excellent tool for multidisciplinary exchange between researchers with different backgrounds, helping to identify the dominant structures and processes in a catchment. In our study we explore whether a perceptual model built upon an intensive field campaign may serve as a blueprint for setting up representative hillslopes in a hydrological model to reproduce the functioning of two distinctly different catchments. We use a physically-based 2D hillslope model which has proven capable to be driven by measured soil-hydrological parameters. A key asset of our approach is that the model structure itself remains a picture of the perceptual model, which is benchmarked against a) geo-physical images of the subsurface and b) observed dynamics of discharge, distributed state variables and fluxes (soil moisture, matric potential and sap flow). Within this approach we are able to set up two behavioral model structures which allow the simulation of the most important hydrological fluxes and state variables in good accordance with available observations within the 19.4 km2 large Colpach catchment and the 4.5 km2 large Wollefsbach catchment in Luxembourg without the necessity of calibration. This corroborates, contrary to the widespread opinion, that a) lower mesoscale catchments may be modelled by representative hillslopes and b) physically

  9. How Are Feedbacks Represented in Land Models?

    Directory of Open Access Journals (Sweden)

    Yang Chen

    2016-09-01

    Full Text Available Land systems are characterised by many feedbacks that can result in complex system behaviour. We defined feedbacks as the two-way influences between the land use system and a related system (e.g., climate, soils and markets, both of which are encompassed by the land system. Land models that include feedbacks thus probably more accurately mimic how land systems respond to, e.g., policy or climate change. However, representing feedbacks in land models is a challenge. We reviewed articles incorporating feedbacks into land models and analysed each with predefined indicators. We found that (1 most modelled feedbacks couple land use systems with transport, soil and market systems, while only a few include feedbacks between land use and social systems or climate systems; (2 equation-based land use models that follow a top-down approach prevail; and (3 feedbacks’ effects on system behaviour remain relatively unexplored. We recommend that land system modellers (1 consider feedbacks between land use systems and social systems; (2 adopt (bottom-up approaches suited to incorporating spatial heterogeneity and better representing land use decision-making; and (3 pay more attention to nonlinear system behaviour and its implications for land system management and policy.

  10. Patient representatives? views on patient information in clinical cancer trials

    OpenAIRE

    Dellson, Pia; Nilbert, Mef; Carlsson, Christina

    2016-01-01

    Background Patient enrolment into clinical trials is based on oral information and informed consent, which includes an information sheet and a consent certificate. The written information should be complete, but at the same time risks being so complex that it may be questioned if a fully informed consent is possible to provide. We explored patient representatives? views and perceptions on the written trial information used in clinical cancer trials. Methods Written patient information leaflet...

  11. Patient representatives' views on patient information in clinical cancer trials

    DEFF Research Database (Denmark)

    Dellson, Pia; Nilbert, Mef; Carlsson, Christina

    2016-01-01

    of future simplified and more attractive informed consent forms. CONCLUSIONS: The emotional and cognitive responses to written patient information reported by patient representatives provides a basis for revised formats in future trials and add to the body of information that support use of plain language......BACKGROUND: Patient enrolment into clinical trials is based on oral information and informed consent, which includes an information sheet and a consent certificate. The written information should be complete, but at the same time risks being so complex that it may be questioned if a fully informed...... consent is possible to provide. We explored patient representatives' views and perceptions on the written trial information used in clinical cancer trials. METHODS: Written patient information leaflets used in four clinical trials for colorectal cancer were used for the study. The trials included phase I...

  12. Patient representatives' views on patient information in clinical cancer trials.

    Science.gov (United States)

    Dellson, Pia; Nilbert, Mef; Carlsson, Christina

    2016-02-01

    Patient enrolment into clinical trials is based on oral information and informed consent, which includes an information sheet and a consent certificate. The written information should be complete, but at the same time risks being so complex that it may be questioned if a fully informed consent is possible to provide. We explored patient representatives' views and perceptions on the written trial information used in clinical cancer trials. Written patient information leaflets used in four clinical trials for colorectal cancer were used for the study. The trials included phase I-III trials, randomized and non-randomized trials that evaluated chemotherapy/targeted therapy in the neoadjuvant, adjuvant and palliative settings. Data were collected through focus groups and were analysed using inductive content analysis. Two major themes emerged: emotional responses and cognitive responses. Subthemes related to the former included individual preferences and perceptions of effect, while subthemes related to the latter were comprehensibility and layout. Based on these observations the patient representatives provided suggestions for improvement, which largely included development of future simplified and more attractive informed consent forms. The emotional and cognitive responses to written patient information reported by patient representatives provides a basis for revised formats in future trials and add to the body of information that support use of plain language, structured text and illustrations to improve the informed consent process and thereby patient enrolment into clinical trials.

  13. Assessing the use of cognitive heuristic representativeness in clinical reasoning.

    Science.gov (United States)

    Payne, Velma L; Crowley, Rebecca S; Crowley, Rebecca

    2008-11-06

    We performed a pilot study to investigate use of the cognitive heuristic Representativeness in clinical reasoning. We tested a set of tasks and assessments to determine whether subjects used the heuristics in reasoning, to obtain initial frequencies of heuristic use and related cognitive errors, and to collect cognitive process data using think-aloud techniques. The study investigates two aspects of the Representativeness heuristic - judging by perceived frequency and representativeness as causal beliefs. Results show that subjects apply both aspects of the heuristic during reasoning, and make errors related to misapplication of these heuristics. Subjects in this study rarely used base rates, showed significant variability in their recall of base rates, demonstrated limited ability to use provided base rates, and favored causal data in diagnosis. We conclude that the tasks and assessments we have developed provide a suitable test-bed to study the cognitive processes underlying heuristic errors.

  14. Assessing Use of Cognitive Heuristic Representativeness in Clinical Reasoning

    Science.gov (United States)

    Payne, Velma L.; Crowley, Rebecca S.

    2008-01-01

    We performed a pilot study to investigate use of the cognitive heuristic Representativeness in clinical reasoning. We tested a set of tasks and assessments to determine whether subjects used the heuristics in reasoning, to obtain initial frequencies of heuristic use and related cognitive errors, and to collect cognitive process data using think-aloud techniques. The study investigates two aspects of the Representativeness heuristic - judging by perceived frequency and representativeness as causal beliefs. Results show that subjects apply both aspects of the heuristic during reasoning, and make errors related to misapplication of these heuristics. Subjects in this study rarely used base rates, showed significant variability in their recall of base rates, demonstrated limited ability to use provided base rates, and favored causal data in diagnosis. We conclude that the tasks and assessments we have developed provide a suitable test-bed to study the cognitive processes underlying heuristic errors. PMID:18999140

  15. Clinical professional governance for detailed clinical models.

    Science.gov (United States)

    Goossen, William; Goossen-Baremans, Anneke

    2013-01-01

    This chapter describes the need for Detailed Clinical Models for contemporary Electronic Health Systems, data exchange and data reuse. It starts with an explanation of the components related to Detailed Clinical Models with a brief summary of knowledge representation, including terminologies representing clinic relevant "things" in the real world, and information models that abstract these in order to let computers process data about these things. Next, Detailed Clinical Models are defined and their purpose is described. It builds on existing developments around the world and accumulates in current work to create a technical specification at the level of the International Standards Organization. The core components of properly expressed Detailed Clinical Models are illustrated, including clinical knowledge and context, data element specification, code bindings to terminologies and meta-information about authors, versioning among others. Detailed Clinical Models to date are heavily based on user requirements and specify the conceptual and logical levels of modelling. It is not precise enough for specific implementations, which requires an additional step. However, this allows Detailed Clinical Models to serve as specifications for many different kinds of implementations. Examples of Detailed Clinical Models are presented both in text and in Unified Modelling Language. Detailed Clinical Models can be positioned in health information architectures, where they serve at the most detailed granular level. The chapter ends with examples of projects that create and deploy Detailed Clinical Models. All have in common that they can often reuse materials from earlier projects, and that strict governance of these models is essential to use them safely in health care information and communication technology. Clinical validation is one point of such governance, and model testing another. The Plan Do Check Act cycle can be applied for governance of Detailed Clinical Models

  16. SPECIFIC MODELS OF REPRESENTING THE INTELLECTUAL CAPITAL

    Directory of Open Access Journals (Sweden)

    Andreea Feraru

    2014-12-01

    Full Text Available Various scientists in the modern age of management have launched different models for evaluating intellectual capital, and some of these models are analysed critically in this study, too. Most authors examine intellectual capital from a static perspective and focus on the development of its various evaluation models. In this chapter we surveyed the classical static models: Sveiby, Edvisson, Balanced Scorecard, as well as the canonical model of intellectual capital. In a spectral dynamic analysis, organisational intellectual capital is structured in: organisational knowledge, organisational intelligence, organisational values, and their value is built on certain mechanisms entitled integrators, whose chief constitutive elements are: individual knowledge, individual intelligence and individual cultural values. The organizations, as employers, must especially reconsider those employees’ work who value knowledge because they are free to choose how, and especially where they are inclined to invest their own energy, skills and time, and they can be treated as freelancers or as some little entrepreneurs .

  17. Representing clinical communication knowledge through database management system integration.

    Science.gov (United States)

    Khairat, Saif; Craven, Catherine; Gong, Yang

    2012-01-01

    Clinical communication failures are considered the leading cause of medical errors [1]. The complexity of the clinical culture and the significant variance in training and education levels form a challenge to enhancing communication within the clinical team. In order to improve communication, a comprehensive understanding of the overall communication process in health care is required. In an attempt to further understand clinical communication, we conducted a thorough methodology literature review to identify strengths and limitations of previous approaches [2]. Our research proposes a new data collection method to study the clinical communication activities among Intensive Care Unit (ICU) clinical teams with a primary focus on the attending physician. In this paper, we present the first ICU communication instrument, and, we introduce the use of database management system to aid in discovering patterns and associations within our ICU communications data repository.

  18. Selection of Representative Models for Decision Analysis Under Uncertainty

    Science.gov (United States)

    Meira, Luis A. A.; Coelho, Guilherme P.; Santos, Antonio Alberto S.; Schiozer, Denis J.

    2016-03-01

    The decision-making process in oil fields includes a step of risk analysis associated with the uncertainties present in the variables of the problem. Such uncertainties lead to hundreds, even thousands, of possible scenarios that are supposed to be analyzed so an effective production strategy can be selected. Given this high number of scenarios, a technique to reduce this set to a smaller, feasible subset of representative scenarios is imperative. The selected scenarios must be representative of the original set and also free of optimistic and pessimistic bias. This paper is devoted to propose an assisted methodology to identify representative models in oil fields. To do so, first a mathematical function was developed to model the representativeness of a subset of models with respect to the full set that characterizes the problem. Then, an optimization tool was implemented to identify the representative models of any problem, considering not only the cross-plots of the main output variables, but also the risk curves and the probability distribution of the attribute-levels of the problem. The proposed technique was applied to two benchmark cases and the results, evaluated by experts in the field, indicate that the obtained solutions are richer than those identified by previously adopted manual approaches. The program bytecode is available under request.

  19. Analysis of Mental Processes Represented in Models of Artificial Consciousness

    Directory of Open Access Journals (Sweden)

    Luana Folchini da Costa

    2013-12-01

    Full Text Available The Artificial Consciousness concept has been used in the engineering area as being an evolution of the Artificial Intelligence. However, consciousness is a complex subject and often used without formalism. As a main contribution, in this work one proposes an analysis of four recent models of artificial consciousness published in the engineering area. The mental processes represented by these models are highlighted and correlations with the theoretical perspective of cognitive psychology are made. Finally, considerations about consciousness in such models are discussed.

  20. Development of a Representative Mouse Model with Nonalcoholic Steatohepatitis.

    Science.gov (United States)

    Verbeek, Jef; Jacobs, Ans; Spincemaille, Pieter; Cassiman, David

    2016-06-01

    Non-alcoholic fatty liver disease (NAFLD) is the most prevalent liver disease in the Western world. It represents a disease spectrum ranging from isolated steatosis to non-alcoholic steatohepatitis (NASH). In particular, NASH can evolve to fibrosis, cirrhosis, hepatocellular carcinoma, and liver failure. The development of novel treatment strategies is hampered by the lack of representative NASH mouse models. Here, we describe a NASH mouse model, which is based on feeding non-genetically manipulated C57BL6/J mice a 'Western style' high-fat/high-sucrose diet (HF-HSD). HF-HSD leads to early obesity, insulin resistance, and hypercholesterolemia. After 12 weeks of HF-HSD, all mice exhibit the complete spectrum of features of NASH, including steatosis, hepatocyte ballooning, and lobular inflammation, together with fibrosis in the majority of mice. Hence, this model closely mimics the human disease. Implementation of this mouse model will lead to a standardized setup for the evaluation of (i) underlying mechanisms that contribute to the progression of NAFLD to NASH, and (ii) therapeutic interventions for NASH. © 2016 by John Wiley & Sons, Inc. Copyright © 2016 John Wiley & Sons, Inc.

  1. Representing the environment 3.0. Maps, models, networks.

    Directory of Open Access Journals (Sweden)

    Letizia Bollini

    2014-05-01

    Full Text Available Web 3.0 is changing the world we live and perceive the environment anthropomorphized, making a stratifation of levels of experience and mediated by the devices. If the urban landscape is designed, shaped and planned space, there is a social landscape that overwrite the territory of values, representations shared images, narratives of personal and collective history. Mobile technology introduces an additional parameter, a kind of non-place, which allows the coexistence of the here and elsewhere in an sort of digital landscape. The maps, mental models, the system of social networks become, then, the way to present, represented and represent themselves in a kind of ideal coring of the co-presence of levels of physical, cognitive and collective space.

  2. Lightweight Expression of Granular Objects (LEGO) Content Modeling Using the SNOMED CT Observables Model to Represent Nursing Assessment Data.

    Science.gov (United States)

    Johnson, Christie

    2016-01-01

    This poster presentation presents a content modeling strategy using the SNOMED CT Observable Model to represent large amounts of detailed clinical data in a consistent and computable manner that can support multiple use cases. Lightweight Expression of Granular Objects (LEGOs) represent question/answer pairs on clinical data collection forms, where a question is modeled by a (usually) post-coordinated SNOMED CT expression. LEGOs transform electronic patient data into a normalized consumable, which means that the expressions can be treated as extensions of the SNOMED CT hierarchies for the purpose of performing subsumption queries and other analytics. Utilizing the LEGO approach for modeling clinical data obtained from a nursing admission assessment provides a foundation for data exchange across disparate information systems and software applications. Clinical data exchange of computable LEGO patient information enables the development of more refined data analytics, data storage and clinical decision support.

  3. Model parameters for representative wetland plant functional groups

    Science.gov (United States)

    Williams, Amber S.; Kiniry, James R.; Mushet, David M.; Smith, Loren M.; McMurry, Scott T.; Attebury, Kelly; Lang, Megan; McCarty, Gregory W.; Shaffer, Jill A.; Effland, William R.; Johnson, Mari-Vaughn V.

    2017-01-01

    Wetlands provide a wide variety of ecosystem services including water quality remediation, biodiversity refugia, groundwater recharge, and floodwater storage. Realistic estimation of ecosystem service benefits associated with wetlands requires reasonable simulation of the hydrology of each site and realistic simulation of the upland and wetland plant growth cycles. Objectives of this study were to quantify leaf area index (LAI), light extinction coefficient (k), and plant nitrogen (N), phosphorus (P), and potassium (K) concentrations in natural stands of representative plant species for some major plant functional groups in the United States. Functional groups in this study were based on these parameters and plant growth types to enable process-based modeling. We collected data at four locations representing some of the main wetland regions of the United States. At each site, we collected on-the-ground measurements of fraction of light intercepted, LAI, and dry matter within the 2013–2015 growing seasons. Maximum LAI and k variables showed noticeable variations among sites and years, while overall averages and functional group averages give useful estimates for multisite simulation modeling. Variation within each species gives an indication of what can be expected in such natural ecosystems. For P and K, the concentrations from highest to lowest were spikerush (Eleocharis macrostachya), reed canary grass (Phalaris arundinacea), smartweed (Polygonum spp.), cattail (Typha spp.), and hardstem bulrush (Schoenoplectus acutus). Spikerush had the highest N concentration, followed by smartweed, bulrush, reed canary grass, and then cattail. These parameters will be useful for the actual wetland species measured and for the wetland plant functional groups they represent. These parameters and the associated process-based models offer promise as valuable tools for evaluating environmental benefits of wetlands and for evaluating impacts of various agronomic practices in

  4. Representing Reservoir Stratification in Land Surface and Earth System Models

    Science.gov (United States)

    Yigzaw, W.; Li, H. Y.; Leung, L. R.; Hejazi, M. I.; Voisin, N.; Payn, R. A.; Demissie, Y.

    2017-12-01

    A one-dimensional reservoir stratification modeling has been developed as part of Model for Scale Adaptive River Transport (MOSART), which is the river transport model used in the Accelerated Climate Modeling for Energy (ACME) and Community Earth System Model (CESM). Reservoirs play an important role in modulating the dynamic water, energy and biogeochemical cycles in the riverine system through nutrient sequestration and stratification. However, most earth system models include lake models that assume a simplified geometry featuring a constant depth and a constant surface area. As reservoir geometry has important effects on thermal stratification, we developed a new algorithm for deriving generic, stratified area-elevation-storage relationships that are applicable at regional and global scales using data from Global Reservoir and Dam database (GRanD). This new reservoir geometry dataset is then used to support the development of a reservoir stratification module within MOSART. The mixing of layers (energy and mass) in the reservoir is driven by eddy diffusion, vertical advection, and reservoir inflow and outflow. Upstream inflow into a reservoir is treated as an additional source/sink of energy, while downstream outflow represented a sink. Hourly atmospheric forcing from North American Land Assimilation System (NLDAS) Phase II and simulated daily runoff by ACME land component are used as inputs for the model over the contiguous United States for simulations between 2001-2010. The model is validated using selected observed temperature profile data in a number of reservoirs that are subject to various levels of regulation. The reservoir stratification module completes the representation of riverine mass and heat transfer in earth system models, which is a major step towards quantitative understanding of human influences on the terrestrial hydrological, ecological and biogeochemical cycles.

  5. Representing the Marginal Stability of Peptides in Coarse Grained Models

    Science.gov (United States)

    Sayar, Mehmet; Dalgicdir, Cahit; Ramezanghorbani, Farhad

    Tertiary structure of proteins is only marginally stable; such that the folded structure is separated from local minima by as little as 10 kcal/mol. In particular for intrinsically disordered peptides, this marginal stability is key to understanding their complex behavior. Bottom-up coarse grained (CG) models for proteins/peptides which rely on structural and/or thermodynamic reference data from experiments or all atom simulations inherently focus on the equilibrium structure and fail to capture the conformational dynamics of the molecule. In this study, we present a CG model for a synthetic peptide, LK, which successfully captures the conformational flexibility of the molecule in different environments. LK peptide is composed of leucine and lysine residues and displays a stark conformational transition from a degenerate conformation in dilute solution to a fully stable alpha-helix at macroscopic and molecular interfaces. In this study we demonstrate that by carefully combining atomistic references from both the unfolded and folded states, one can create a CG model that can represent not only the folded state, but also the conformational transitions that the peptide exhibits in response to changes in the environment. M. Sayar thanks TÜBİTAK (Grant No. 212T184) and TÜBA Distinguished Young Scientist Award (2012 awardee) for financial support.

  6. Modeling of Cementitious Representative Volume Element with Additives

    Science.gov (United States)

    Shahzamanian, M. M.; Basirun, W. J.

    CEMHYD3D has been employed to simulate the representative volume element (RVE) of cementitious systems (Type I cement) containing fly ash (Class F) through a voxel-based finite element analysis (FEA) approach. Three-dimensional microstructures composed of voxels are generated for a heterogeneous cementitious material consisting of various constituent phases. The primary focus is to simulate a cementitious RVE containing fly ash and to present the homogenized macromechanical properties obtained from its analysis. Simple kinematic uniform boundary conditions as well as periodic boundary conditions were imposed on the RVE to obtain the principal and shear moduli. Our current work considers the effect of fly ash percentage on the elastic properties based on the mass and volume replacements. RVEs with lengths of 50, 100 and 200μm at different degrees of hydration are generated, and the elastic properties are modeled and simulated. In general, the elastic properties of a cementitious RVE with fly ash replacement for cement based on mass and volume differ from each other. Moreover, the finite element (FE) mesh density effect is studied. Results indicate that mechanical properties decrease with increasing mesh density.

  7. Social tagging: a model for representing information in the blogosphere

    Directory of Open Access Journals (Sweden)

    Elaine Pérez Sanchidrián

    2015-04-01

    Full Text Available Objective: The study addresses the theoretical and conceptual aspects related to social labeling. Has the advantages of labels on different platforms of Web 2.0. Exposes some of the major sites of social labeling system including Flickr, Delicious, Technorati is destcan, among others. Terminologically analyzed using the tags in the blogosphere as a model for representing information. Methods: The research took as methods of qualitative content analysis to identify the behavior of the international literature on this subject and the metric analysis to characterize the use of social labeling in the blogosphere. Results: The study led to qualitatively describe the use of labels on blogs and their terminological particularities associated with the following aspects: creating labels in these spaces is related to a number of social issues among which we can highlight: Politics, Culture, economy, Gender, History, Sexuality, Discrimination, Health, Environment, Technology. The labels on these platforms are defined from the general to the particular and there is no limit concurrency for its creation, usually the authors cite for each post 4-7 labels in order to spread their content as possible in the community. Conclusions: This study enables reflect the social impact of using labels on platforms like blogs.

  8. Chemistry education based on concepts represented by mental models

    OpenAIRE

    Gibin, Gustavo Bizarria; Ferreira, Luiz Henrique

    2010-01-01

    The current legislation determines that the chemist must have a solid comprehension about chemical concepts. Literature presents the concept of mental model, which is determinant to the learning of phenomena and concepts. This paper presents some mental models that students of the Chemistry course at UFSCar have about chemical concepts. A lot of incoherence was observed in student's mental models, which is an evidence that there are problems in the learning of chemistry education.

  9. Validating EHR clinical models using ontology patterns.

    Science.gov (United States)

    Martínez-Costa, Catalina; Schulz, Stefan

    2017-12-01

    Clinical models are artefacts that specify how information is structured in electronic health records (EHRs). However, the makeup of clinical models is not guided by any formal constraint beyond a semantically vague information model. We address this gap by advocating ontology design patterns as a mechanism that makes the semantics of clinical models explicit. This paper demonstrates how ontology design patterns can validate existing clinical models using SHACL. Based on the Clinical Information Modelling Initiative (CIMI), we show how ontology patterns detect both modeling and terminology binding errors in CIMI models. SHACL, a W3C constraint language for the validation of RDF graphs, builds on the concept of "Shape", a description of data in terms of expected cardinalities, datatypes and other restrictions. SHACL, as opposed to OWL, subscribes to the Closed World Assumption (CWA) and is therefore more suitable for the validation of clinical models. We have demonstrated the feasibility of the approach by manually describing the correspondences between six CIMI clinical models represented in RDF and two SHACL ontology design patterns. Using a Java-based SHACL implementation, we found at least eleven modeling and binding errors within these CIMI models. This demonstrates the usefulness of ontology design patterns not only as a modeling tool but also as a tool for validation. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Acquiring, Representing, and Evaluating a Competence Model of Diagnostic Strategy.

    Science.gov (United States)

    Clancey, William J.

    This paper describes NEOMYCIN, a computer program that models one physician's diagnostic reasoning within a limited area of medicine. NEOMYCIN's knowledge base and reasoning procedure constitute a model of how human knowledge is organized and how it is used in diagnosis. The hypothesis is tested that such a procedure can be used to simulate both…

  11. Modeling Methodologies for Representing Urban Cultural Geographies in Stability Operations

    National Research Council Canada - National Science Library

    Ferris, Todd P

    2008-01-01

    ... 2.0.0, in an effort to provide modeling methodologies for a single simulation tool capable of exploring the complex world of urban cultural geographies undergoing Stability Operations in an irregular warfare (IW) environment...

  12. Representing and managing uncertainty in qualitative ecological models

    NARCIS (Netherlands)

    Nuttle, T.; Bredeweg, B.; Salles, P.; Neumann, M.

    2009-01-01

    Ecologists and decision makers need ways to understand systems, test ideas, and make predictions and explanations about systems. However, uncertainty about causes and effects of processes and parameter values is pervasive in models of ecological systems. Uncertainty associated with incomplete

  13. Molecular Simulation towards Efficient and Representative Subsurface Reservoirs Modeling

    KAUST Repository

    Kadoura, Ahmad Salim

    2016-01-01

    This dissertation focuses on the application of Monte Carlo (MC) molecular simulation and Molecular Dynamics (MD) in modeling thermodynamics and flow of subsurface reservoir fluids. At first, MC molecular simulation is proposed as a promising method

  14. Representing the Past by Solid Modeling + Golden Ratio Analysis

    Science.gov (United States)

    Ding, Suining

    2008-01-01

    This paper describes the procedures of reconstructing ancient architecture using solid modeling with geometric analysis, especially the Golden Ratio analysis. In the past the recovery and reconstruction of ruins required bringing together fragments of evidence and vast amount of measurements from archaeological site. Although researchers and…

  15. Representing climate, disturbance, and vegetation interactions in landscape models

    Science.gov (United States)

    Robert E. Keane; Donald McKenzie; Donald A. Falk; Erica A.H. Smithwick; Carol Miller; Lara-Karena B. Kellogg

    2015-01-01

    The prospect of rapidly changing climates over the next century calls for methods to predict their effects on myriad, interactive ecosystem processes. Spatially explicit models that simulate ecosystem dynamics at fine (plant, stand) to coarse (regional, global) scales are indispensable tools for meeting this challenge under a variety of possible futures. A special...

  16. A Topic Model Approach to Representing and Classifying Football Plays

    KAUST Repository

    Varadarajan, Jagannadan

    2013-09-09

    We address the problem of modeling and classifying American Football offense teams’ plays in video, a challenging example of group activity analysis. Automatic play classification will allow coaches to infer patterns and tendencies of opponents more ef- ficiently, resulting in better strategy planning in a game. We define a football play as a unique combination of player trajectories. To this end, we develop a framework that uses player trajectories as inputs to MedLDA, a supervised topic model. The joint maximiza- tion of both likelihood and inter-class margins of MedLDA in learning the topics allows us to learn semantically meaningful play type templates, as well as, classify different play types with 70% average accuracy. Furthermore, this method is extended to analyze individual player roles in classifying each play type. We validate our method on a large dataset comprising 271 play clips from real-world football games, which will be made publicly available for future comparisons.

  17. A Knowledge base representing Porter's Five Forces Model

    OpenAIRE

    Swaan Arons, H.; Waalewijn, Ph.

    1999-01-01

    textabstractStrategic Analysis and Planning is a field in which expertise and experience are key factors. In order to decide on strategic matters such as the competitive position of a company experts heavily lean on their ability to reason with uncertain or incomplete knowledge, or in other words on their experience and expertise. An important aspect is to assess a company's profit potential in the industry for which Porter's Competitive Forces Model is by far the most widely used framework. ...

  18. Model Complexities of Shallow Networks Representing Highly Varying Functions

    Czech Academy of Sciences Publication Activity Database

    Kůrková, Věra; Sanguineti, M.

    2016-01-01

    Roč. 171, 1 January (2016), s. 598-604 ISSN 0925-2312 R&D Projects: GA MŠk(CZ) LD13002 Grant - others:grant for Visiting Professors(IT) GNAMPA-INdAM Institutional support: RVO:67985807 Keywords : shallow networks * model complexity * highly varying functions * Chernoff bound * perceptrons * Gaussian kernel units Subject RIV: IN - Informatics, Computer Science Impact factor: 3.317, year: 2016

  19. Physically representative atomistic modeling of atomic-scale friction

    Science.gov (United States)

    Dong, Yalin

    Nanotribology is a research field to study friction, adhesion, wear and lubrication occurred between two sliding interfaces at nano scale. This study is motivated by the demanding need of miniaturization mechanical components in Micro Electro Mechanical Systems (MEMS), improvement of durability in magnetic storage system, and other industrial applications. Overcoming tribological failure and finding ways to control friction at small scale have become keys to commercialize MEMS with sliding components as well as to stimulate the technological innovation associated with the development of MEMS. In addition to the industrial applications, such research is also scientifically fascinating because it opens a door to understand macroscopic friction from the most bottom atomic level, and therefore serves as a bridge between science and engineering. This thesis focuses on solid/solid atomic friction and its associated energy dissipation through theoretical analysis, atomistic simulation, transition state theory, and close collaboration with experimentalists. Reduced-order models have many advantages for its simplification and capacity to simulating long-time event. We will apply Prandtl-Tomlinson models and their extensions to interpret dry atomic-scale friction. We begin with the fundamental equations and build on them step-by-step from the simple quasistatic one-spring, one-mass model for predicting transitions between friction regimes to the two-dimensional and multi-atom models for describing the effect of contact area. Theoretical analysis, numerical implementation, and predicted physical phenomena are all discussed. In the process, we demonstrate the significant potential for this approach to yield new fundamental understanding of atomic-scale friction. Atomistic modeling can never be overemphasized in the investigation of atomic friction, in which each single atom could play a significant role, but is hard to be captured experimentally. In atomic friction, the

  20. Manipulating Models and Grasping the Ideas They Represent

    Science.gov (United States)

    Bryce, T. G. K.; Blown, E. J.

    2016-03-01

    This article notes the convergence of recent thinking in neuroscience and grounded cognition regarding the way we understand mental representation and recollection: ideas are dynamic and multi-modal, actively created at the point of recall. Also, neurophysiologically, re-entrant signalling among cortical circuits allows non-conscious processing to support our deliberative thoughts and actions. The qualitative research we describe examines the exchanges occurring during semi-structured interviews with 360 children age 3-13, including 294 from New Zealand (158 boys, 136 girls) and 66 from China (34 boys, 32 girls) concerning their understanding of the shape and motion of the Earth, Sun and Moon (ESM). We look closely at the relationships between what is revealed as children manipulate their own play-dough models and their apparent understandings of ESM concepts. In particular, we focus on the switching taking place between what is said, what is drawn and what is modelled. The evidence is supportive of Edelman's view that memory is non-representational and that concepts are the outcome of perceptual mappings, a view which is also in accord with Barsalou's notion that concepts are simulators or skills which operate consistently across several modalities. Quantitative data indicate that the dynamic structure of memory/concept creation is similar in both genders and common to the cultures/ethnicities compared (New Zealand European and Māori; Chinese Han) and that repeated interviews in this longitudinal research lead to more advanced modelling skills and/or more advanced shape and motion concepts, the results supporting hypotheses ( Kolmogorov- Smirnov alpha levels .05; r s : p < .001).

  1. Model analysis: Representing and assessing the dynamics of student learning

    Directory of Open Access Journals (Sweden)

    Lei Bao

    2006-02-01

    Full Text Available Decades of education research have shown that students can simultaneously possess alternate knowledge frameworks and that the development and use of such knowledge are context dependent. As a result of extensive qualitative research, standardized multiple-choice tests such as Force Concept Inventory and Force-Motion Concept Evaluation tests provide instructors tools to probe their students’ conceptual knowledge of physics. However, many existing quantitative analysis methods often focus on a binary question of whether a student answers a question correctly or not. This greatly limits the capacity of using the standardized multiple-choice tests in assessing students’ alternative knowledge. In addition, the context dependence issue, which suggests that a student may apply the correct knowledge in some situations and revert to use alternative types of knowledge in others, is often treated as random noise in current analyses. In this paper, we present a model analysis, which applies qualitative research to establish a quantitative representation framework. With this method, students’ alternative knowledge and the probabilities for students to use such knowledge in a range of equivalent contexts can be quantitatively assessed. This provides a way to analyze research-based multiple choice questions, which can generate much richer information than what is available from score-based analysis.

  2. Feasibility of representing a Danish Microbiology Model using FHIR

    DEFF Research Database (Denmark)

    Andersen, Mie Vestergaard; Kristensen, Ida Hvass; Larsen, Malene Møller

    2017-01-01

    In Danish home care, multiple professions deliver services to citizens. FSIII is a national home care documentation standard, where one of the goals is to share documentation to improve coordination between these professional groups and avoid double documentation. The aim of this study was to dev......In Danish home care, multiple professions deliver services to citizens. FSIII is a national home care documentation standard, where one of the goals is to share documentation to improve coordination between these professional groups and avoid double documentation. The aim of this study...... to SNOMED CT, visualization of merged graphs, identification of reference concepts, relating reference concepts to the documentation models of each profession, and representation of the navigation hierarchy in a reference set. The navigation hierarchy ensures that citizen conditions appear in a relevant...... context, regardless of which profession entered the data. Our approach paves the way for incremental standardization projects, where an implementation artefact, such as the navigation hierarchy, highlights the semantic features of SNOMED CT that can be used to reach specific business goals; in this case...

  3. Molecular Simulation towards Efficient and Representative Subsurface Reservoirs Modeling

    KAUST Repository

    Kadoura, Ahmad

    2016-09-01

    This dissertation focuses on the application of Monte Carlo (MC) molecular simulation and Molecular Dynamics (MD) in modeling thermodynamics and flow of subsurface reservoir fluids. At first, MC molecular simulation is proposed as a promising method to replace correlations and equations of state in subsurface flow simulators. In order to accelerate MC simulations, a set of early rejection schemes (conservative, hybrid, and non-conservative) in addition to extrapolation methods through reweighting and reconstruction of pre-generated MC Markov chains were developed. Furthermore, an extensive study was conducted to investigate sorption and transport processes of methane, carbon dioxide, water, and their mixtures in the inorganic part of shale using both MC and MD simulations. These simulations covered a wide range of thermodynamic conditions, pore sizes, and fluid compositions shedding light on several interesting findings. For example, the possibility to have more carbon dioxide adsorbed with more preadsorbed water concentrations at relatively large basal spaces. The dissertation is divided into four chapters. The first chapter corresponds to the introductory part where a brief background about molecular simulation and motivations are given. The second chapter is devoted to discuss the theoretical aspects and methodology of the proposed MC speeding up techniques in addition to the corresponding results leading to the successful multi-scale simulation of the compressible single-phase flow scenario. In chapter 3, the results regarding our extensive study on shale gas at laboratory conditions are reported. At the fourth and last chapter, we end the dissertation with few concluding remarks highlighting the key findings and summarizing the future directions.

  4. Models with Men and Women: Representing Gender in Dynamic Modeling of Social Systems.

    Science.gov (United States)

    Palmer, Erika; Wilson, Benedicte

    2018-04-01

    Dynamic engineering models have yet to be evaluated in the context of feminist engineering ethics. Decision-making concerning gender in dynamic modeling design is a gender and ethical issue that is important to address regardless of the system in which the dynamic modeling is applied. There are many dynamic modeling tools that operationally include the female population, however, there is an important distinction between females and women; it is the difference between biological sex and the social construct of gender, which is fluid and changes over time and geography. The ethical oversight in failing to represent or misrepresenting gender in model design when it is relevant to the model purpose can have implications for model validity and policy model development. This paper highlights this gender issue in the context of feminist engineering ethics using a dynamic population model. Women are often represented in this type of model only in their biological capacity, while lacking their gender identity. This illustrative example also highlights how language, including the naming of variables and communication with decision-makers, plays a role in this gender issue.

  5. Detailed clinical models: a review.

    Science.gov (United States)

    Goossen, William; Goossen-Baremans, Anneke; van der Zel, Michael

    2010-12-01

    Due to the increasing use of electronic patient records and other health care information technology, we see an increase in requests to utilize these data. A highly level of standardization is required during the gathering of these data in the clinical context in order to use it for analyses. Detailed Clinical Models (DCM) have been created toward this purpose and several initiatives have been implemented in various parts of the world to create standardized models. This paper presents a review of DCM. Two types of analyses are presented; one comparing DCM against health care information architectures and a second bottom up approach from concept analysis to representation. In addition core parts of the draft ISO standard 13972 on DCM are used such as clinician involvement, data element specification, modeling, meta information, and repository and governance. SIX INITIATIVES WERE SELECTED: Intermountain Healthcare, 13606/OpenEHR Archetypes, Clinical Templates, Clinical Contents Models, Health Level 7 templates, and Dutch Detailed Clinical Models. Each model selected was reviewed for their overall development, involvement of clinicians, use of data types, code bindings, expressing semantics, modeling, meta information, use of repository and governance. Using both a top down and bottom up approach to comparison reveals many commonalties and differences between initiatives. Important differences include the use of or lack of a reference model and expressiveness of models. Applying clinical data element standards facilitates the use of conceptual DCM models in different technical representations.

  6. A Statistical and Spectral Model for Representing Noisy Sounds with Short-Time Sinusoids

    Directory of Open Access Journals (Sweden)

    Myriam Desainte-Catherine

    2005-07-01

    Full Text Available We propose an original model for noise analysis, transformation, and synthesis: the CNSS model. Noisy sounds are represented with short-time sinusoids whose frequencies and phases are random variables. This spectral and statistical model represents information about the spectral density of frequencies. This perceptually relevant property is modeled by three mathematical parameters that define the distribution of the frequencies. This model also represents the spectral envelope. The mathematical parameters are defined and the analysis algorithms to extract these parameters from sounds are introduced. Then algorithms for generating sounds from the parameters of the model are presented. Applications of this model include tools for composers, psychoacoustic experiments, and pedagogy.

  7. Role Modeling for Clinical Educators.

    Science.gov (United States)

    Ettinger, Ellen Richter

    1991-01-01

    To become better role models, higher educators in institutions of clinical education should be conscious of the behaviors they demonstrate and the broad range of activities and attitudes that students observe and emulate, including clinical competence, professional demeanor, doctor-patient interactions, ethical values, and social consciousness.…

  8. Representative Model of the Learning Process in Virtual Spaces Supported by ICT

    Science.gov (United States)

    Capacho, José

    2014-01-01

    This paper shows the results of research activities for building the representative model of the learning process in virtual spaces (e-Learning). The formal basis of the model are supported in the analysis of models of learning assessment in virtual spaces and specifically in Dembo´s teaching learning model, the systemic approach to evaluating…

  9. Use of single-representative reverse-engineered surface-models for RSA does not affect measurement accuracy and precision.

    Science.gov (United States)

    Seehaus, Frank; Schwarze, Michael; Flörkemeier, Thilo; von Lewinski, Gabriela; Kaptein, Bart L; Jakubowitz, Eike; Hurschler, Christof

    2016-05-01

    Implant migration can be accurately quantified by model-based Roentgen stereophotogrammetric analysis (RSA), using an implant surface model to locate the implant relative to the bone. In a clinical situation, a single reverse engineering (RE) model for each implant type and size is used. It is unclear to what extent the accuracy and precision of migration measurement is affected by implant manufacturing variability unaccounted for by a single representative model. Individual RE models were generated for five short-stem hip implants of the same type and size. Two phantom analyses and one clinical analysis were performed: "Accuracy-matched models": one stem was assessed, and the results from the original RE model were compared with randomly selected models. "Accuracy-random model": each of the five stems was assessed and analyzed using one randomly selected RE model. "Precision-clinical setting": implant migration was calculated for eight patients, and all five available RE models were applied to each case. For the two phantom experiments, the 95%CI of the bias ranged from -0.28 mm to 0.30 mm for translation and -2.3° to 2.5° for rotation. In the clinical setting, precision is less than 0.5 mm and 1.2° for translation and rotation, respectively, except for rotations about the proximodistal axis (RSA can be achieved and are not biased by using a single representative RE model. At least for implants similar in shape to the investigated short-stem, individual models are not necessary. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:903-910, 2016. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  10. A constitutive model for representing coupled creep, fracture, and healing in rock salt

    International Nuclear Information System (INIS)

    Chan, K.S.; Bodner, S.R.; Munson, D.E.; Fossum, A.F.

    1996-01-01

    The development of a constitutive model for representing inelastic flow due to coupled creep, damage, and healing in rock salt is present in this paper. This model, referred to as Multimechanism Deformation Coupled Fracture model, has been formulated by considering individual mechanisms that include dislocation creep, shear damage, tensile damage, and damage healing. Applications of the model to representing the inelastic flow and fracture behavior of WIPP salt subjected to creep, quasi-static loading, and damage healing conditions are illustrated with comparisons of model calculations against experimental creep curves, stress-strain curves, strain recovery curves, time-to-rupture data, and fracture mechanism maps

  11. Do patients discharged from advanced practice physiotherapy-led clinics re-present to specialist medical services?

    Science.gov (United States)

    Chang, Angela T; Gavaghan, Belinda; O'Leary, Shaun; McBride, Liza-Jane; Raymer, Maree

    2017-05-15

    Objective The aim of the present study was to determine the rates of re-referral to specialist out-patient clinics for patients previously managed and discharged from an advanced practice physiotherapy-led service in three metropolitan hospitals. Methods A retrospective audit was undertaken of 462 patient cases with non-urgent musculoskeletal conditions discharged between 1 April 2014 and 30 March 2015 from three metropolitan hospitals. These patients had been discharged from the physiotherapy-led service without requiring specialist medical review. Rates and patterns of re-referral to specialist orthopaedic, neurosurgical, chronic pain, or rheumatology services within 12 months of discharge were investigated. Results Forty-six of the 462 patients (10.0%) who were managed by the physiotherapy-led service were re-referred to specialist medical orthopaedic, neurosurgical, chronic pain or rheumatology departments within 12 months of discharge. Only 22 of these patients (4.8%) were re-referred for the same condition as managed previously and discharged. Conclusions Ninety-five per cent of patients with non-urgent musculoskeletal conditions managed by an advanced practice physiotherapy-led service at three metropolitan hospitals did not re-present to access public specialist medical services for the same condition within 12 months of discharge. This is the first time that re-presentation rates have been reported for patients managed in advanced practice physiotherapy services and the findings support the effectiveness of these models of care in managing demand for speciality out-patient services. What is known about the topic? Advanced practice physiotherapy-led services have been implemented to address the needs of patients referred with non-urgent musculoskeletal conditions to hospital specialist out-patient services. Although this model is widely used in Australia, there has been very little information about whether patients managed in these services subsequently re-present

  12. The Model Method: Singapore Children's Tool for Representing and Solving Algebraic Word Problems

    Science.gov (United States)

    Ng, Swee Fong; Lee, Kerry

    2009-01-01

    Solving arithmetic and algebraic word problems is a key component of the Singapore elementary mathematics curriculum. One heuristic taught, the model method, involves drawing a diagram to represent key information in the problem. We describe the model method and a three-phase theoretical framework supporting its use. We conducted 2 studies to…

  13. Reduction of the Number of Major Representative Allergens: From Clinical Testing to 3-Dimensional Structures

    Directory of Open Access Journals (Sweden)

    Ying He

    2014-01-01

    Full Text Available Vast amounts of allergen sequence data have been accumulated, thus complicating the identification of specific allergenic proteins when performing diagnostic allergy tests and immunotherapy. This study aims to rank the importance/potency of the allergens so as to logically reduce the number of allergens and/or allergenic sources. Meta-analysis of 62 allergenic sources used for intradermal testing on 3,335 allergic patients demonstrated that in southern China, mite, sesame, spiny amaranth, Pseudomonas aeruginosa, and house dust account for 88.0% to 100% of the observed positive reactions to the 62 types of allergenic sources tested. The Kolmogorov-Smironov Test results of the website-obtained allergen data and allergen family featured peptides suggested that allergen research in laboratories worldwide has been conducted in parallel on many of the same species. The major allergens were reduced to 21 representative allergens, which were further divided into seven structural classes, each of which contains similar structural components. This study therefore has condensed numerous allergenic sources and major allergens into fewer major representative ones, thus allowing for the use of a smaller number of allergens when conducting comprehensive allergen testing and immunotherapy treatments.

  14. Explicitly represented polygon wall boundary model for the explicit MPS method

    Science.gov (United States)

    Mitsume, Naoto; Yoshimura, Shinobu; Murotani, Kohei; Yamada, Tomonori

    2015-05-01

    This study presents an accurate and robust boundary model, the explicitly represented polygon (ERP) wall boundary model, to treat arbitrarily shaped wall boundaries in the explicit moving particle simulation (E-MPS) method, which is a mesh-free particle method for strong form partial differential equations. The ERP model expresses wall boundaries as polygons, which are explicitly represented without using the distance function. These are derived so that for viscous fluids, and with less computational cost, they satisfy the Neumann boundary condition for the pressure and the slip/no-slip condition on the wall surface. The proposed model is verified and validated by comparing computed results with the theoretical solution, results obtained by other models, and experimental results. Two simulations with complex boundary movements are conducted to demonstrate the applicability of the E-MPS method to the ERP model.

  15. A framework for extracting and representing project knowledge contexts using topic models and dynamic knowledge maps

    Science.gov (United States)

    Xu, Jin; Li, Zheng; Li, Shuliang; Zhang, Yanyan

    2015-07-01

    There is still a lack of effective paradigms and tools for analysing and discovering the contents and relationships of project knowledge contexts in the field of project management. In this paper, a new framework for extracting and representing project knowledge contexts using topic models and dynamic knowledge maps under big data environments is proposed and developed. The conceptual paradigm, theoretical underpinning, extended topic model, and illustration examples of the ontology model for project knowledge maps are presented, with further research work envisaged.

  16. Using standardized patients versus video cases for representing clinical problems in problem-based learning.

    Science.gov (United States)

    Yoon, Bo Young; Choi, Ikseon; Choi, Seokjin; Kim, Tae-Hee; Roh, Hyerin; Rhee, Byoung Doo; Lee, Jong-Tae

    2016-06-01

    The quality of problem representation is critical for developing students' problem-solving abilities in problem-based learning (PBL). This study investigates preclinical students' experience with standardized patients (SPs) as a problem representation method compared to using video cases in PBL. A cohort of 99 second-year preclinical students from Inje University College of Medicine (IUCM) responded to a Likert scale questionnaire on their learning experiences after they had experienced both video cases and SPs in PBL. The questionnaire consisted of 14 items with eight subcategories: problem identification, hypothesis generation, motivation, collaborative learning, reflective thinking, authenticity, patient-doctor communication, and attitude toward patients. The results reveal that using SPs led to the preclinical students having significantly positive experiences in boosting patient-doctor communication skills; the perceived authenticity of their clinical situations; development of proper attitudes toward patients; and motivation, reflective thinking, and collaborative learning when compared to using video cases. The SPs also provided more challenges than the video cases during problem identification and hypotheses generation. SPs are more effective than video cases in delivering higher levels of authenticity in clinical problems for PBL. The interaction with SPs engages preclinical students in deeper thinking and discussion; growth of communication skills; development of proper attitudes toward patients; and motivation. Considering the higher cost of SPs compared with video cases, SPs could be used most advantageously during the preclinical period in the IUCM curriculum.

  17. Modeling and Depletion Simulations for a High Flux Isotope Reactor Cycle with a Representative Experiment Loading

    Energy Technology Data Exchange (ETDEWEB)

    Chandler, David [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Reactor and Nuclear Systems Division; Betzler, Ben [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Reactor and Nuclear Systems Division; Hirtz, Gregory John [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Reactor and Nuclear Systems Division; Ilas, Germina [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Reactor and Nuclear Systems Division; Sunny, Eva [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States). Reactor and Nuclear Systems Division

    2016-09-01

    The purpose of this report is to document a high-fidelity VESTA/MCNP High Flux Isotope Reactor (HFIR) core model that features a new, representative experiment loading. This model, which represents the current, high-enriched uranium fuel core, will serve as a reference for low-enriched uranium conversion studies, safety-basis calculations, and other research activities. A new experiment loading model was developed to better represent current, typical experiment loadings, in comparison to the experiment loading included in the model for Cycle 400 (operated in 2004). The new experiment loading model for the flux trap target region includes full length 252Cf production targets, 75Se production capsules, 63Ni production capsules, a 188W production capsule, and various materials irradiation targets. Fully loaded 238Pu production targets are modeled in eleven vertical experiment facilities located in the beryllium reflector. Other changes compared to the Cycle 400 model are the high-fidelity modeling of the fuel element side plates and the material composition of the control elements. Results obtained from the depletion simulations with the new model are presented, with a focus on time-dependent isotopic composition of irradiated fuel and single cycle isotope production metrics.

  18. Representativeness and optimal use of body mass index (BMI) in the UK Clinical Practice Research Datalink (CPRD)

    Science.gov (United States)

    Bhaskaran, Krishnan; Forbes, Harriet J; Douglas, Ian; Leon, David A; Smeeth, Liam

    2013-01-01

    Objectives To assess the completeness and representativeness of body mass index (BMI) data in the Clinical Practice Research Datalink (CPRD), and determine an optimal strategy for their use. Design Descriptive study. Setting Electronic healthcare records from primary care. Participants A million patient random sample from the UK CPRD primary care database, aged ≥16 years. Primary and secondary outcome measures BMI completeness in CPRD was evaluated by age, sex and calendar period. CPRD-based summary BMI statistics for each calendar year (2003–2010) were age-standardised and sex-standardised and compared with equivalent statistics from the Health Survey for England (HSE). Results BMI completeness increased over calendar time from 37% in 1990–1994 to 77% in 2005–2011, was higher among females and increased with age. When BMI at specific time points was assigned based on the most recent record, calendar–year-specific mean BMI statistics underestimated equivalent HSE statistics by 0.75–1.1 kg/m2. Restriction to those with a recent (≤3 years) BMI resulted in mean BMI estimates closer to HSE (≤0.28 kg/m2 underestimation), but excluded up to 47% of patients. An alternative strategy of imputing up-to-date BMI based on modelled changes in BMI over time since the last available record also led to mean BMI estimates that were close to HSE (≤0.37 kg/m2 underestimation). Conclusions Completeness of BMI in CPRD increased over time and varied by age and sex. At a given point in time, a large proportion of the most recent BMIs are unlikely to reflect current BMI; consequent BMI misclassification might be reduced by employing model-based imputation of current BMI. PMID:24038008

  19. Combining 3d Volume and Mesh Models for Representing Complicated Heritage Buildings

    Science.gov (United States)

    Tsai, F.; Chang, H.; Lin, Y.-W.

    2017-08-01

    This study developed a simple but effective strategy to combine 3D volume and mesh models for representing complicated heritage buildings and structures. The idea is to seamlessly integrate 3D parametric or polyhedral models and mesh-based digital surfaces to generate a hybrid 3D model that can take advantages of both modeling methods. The proposed hybrid model generation framework is separated into three phases. Firstly, after acquiring or generating 3D point clouds of the target, these 3D points are partitioned into different groups. Secondly, a parametric or polyhedral model of each group is generated based on plane and surface fitting algorithms to represent the basic structure of that region. A "bare-bones" model of the target can subsequently be constructed by connecting all 3D volume element models. In the third phase, the constructed bare-bones model is used as a mask to remove points enclosed by the bare-bones model from the original point clouds. The remaining points are then connected to form 3D surface mesh patches. The boundary points of each surface patch are identified and these boundary points are projected onto the surfaces of the bare-bones model. Finally, new meshes are created to connect the projected points and original mesh boundaries to integrate the mesh surfaces with the 3D volume model. The proposed method was applied to an open-source point cloud data set and point clouds of a local historical structure. Preliminary results indicated that the reconstructed hybrid models using the proposed method can retain both fundamental 3D volume characteristics and accurate geometric appearance with fine details. The reconstructed hybrid models can also be used to represent targets in different levels of detail according to user and system requirements in different applications.

  20. The immature dentate gyrus represents a shared phenotype of mouse models of epilepsy and psychiatric disease.

    Science.gov (United States)

    Shin, Rick; Kobayashi, Katsunori; Hagihara, Hideo; Kogan, Jeffrey H; Miyake, Shinichi; Tajinda, Katsunori; Walton, Noah M; Gross, Adam K; Heusner, Carrie L; Chen, Qian; Tamura, Kouichi; Miyakawa, Tsuyoshi; Matsumoto, Mitsuyuki

    2013-06-01

    There is accumulating evidence to suggest psychiatric disorders, such as bipolar disorder and schizophrenia, share common etiologies, pathophysiologies, genetics, and drug responses with many of the epilepsies. Here, we explored overlaps in cellular/molecular, electrophysiological, and behavioral phenotypes between putative mouse models of bipolar disorder/schizophrenia and epilepsy. We tested the hypothesis that an immature dentate gyrus (iDG), whose association with psychosis in patients has recently been reported, represents a common phenotype of both diseases. Behaviors of calcium/calmodulin-dependent protein kinase II alpha (α-CaMKII) heterozygous knock-out (KO) mice, which are a representative bipolar disorder/schizophrenia model displaying iDG, and pilocarpine-treated mice, which are a representative epilepsy model, were tested followed by quantitative polymerase chain reaction (qPCR)/immunohistochemistry for mRNA/protein expression associated with an iDG phenotype. In vitro electrophysiology of dentate gyrus granule cells (DG GCs) was examined in pilocarpine-treated epileptic mice. The two disease models demonstrated similar behavioral deficits, such as hyperactivity, poor working memory performance, and social withdrawal. Significant reductions in mRNA expression and immunoreactivity of the mature neuronal marker calbindin and concomitant increases in mRNA expression and immunoreactivity of the immature neuronal marker calretinin represent iDG signatures that are present in both mice models. Electrophysiologically, we have confirmed that DG GCs from pilocarpine-treated mice represent an immature state. A significant decrease in hippocampal α-CaMKII protein levels was also found in both models. Our data have shown iDG signatures from mouse models of both bipolar disorder/schizophrenia and epilepsy. The evidence suggests that the iDG may, in part, be responsible for the abnormal behavioral phenotype, and that the underlying pathophysiologies in epilepsy

  1. Cream of the Crop: Clinical Representativeness of Eligible and Ineligible Cannabis Users in Research.

    Science.gov (United States)

    Rosen, Alexis S; Sodos, Louise M; Hirst, Rayna B; Vaughn, Dylan; Lorkiewicz, Sara A

    2018-03-06

    Experts have recommended criteria (Gonzalez et al., 2002) for recruiting pure chronic cannabis users (i.e., those without polysubstance use or psychiatric illness) when evaluating cannabis' non-acute effects on cognition. We sought to demonstrate the implications of using such criteria by examining characteristics of respondents who completed an eligibility screening for a parent study evaluating the cognitive effects of chronic cannabis use. Over a 3-year, 8-month period, 612 respondents from the community completed an eligibility screening based on recommendations in the cannabis literature. Using independent samples t-tests and chi-square tests, we examined whether qualified/eligible respondents (n = 219) differed from non-qualified/ineligible respondents (n = 393). Compared to ineligible cannabis users, eligible cannabis-using respondents were significantly younger, used cannabis more frequently, used alcohol less frequently, and were less likely to have a history of other drug use, a psychiatric diagnosis, or to have used psychiatric medication. Conclusions/Importance: Our findings indicate that eligible/pure cannabis users are not representative of typical cannabis users in the general community (i.e., ineligible users with polysubstance use and/or psychiatric diagnoses) who ultimately comprised the majority of our cannabis-using sample (65.2%). Thus, typical cannabis users may be more accurately characterized as polysubstance users, posing a number of challenges related to the generalizability of findings from studies utilizing pure samples of cannabis users. Recruiting samples of typical cannabis users will improve external validity in research. Furthermore, reporting comprehensive characteristics of such samples will enable consumers to gauge the applicability of study findings to populations of interest.

  2. Buffer AVL Alone Does Not Inactivate Ebola Virus in a Representative Clinical Sample Type.

    Science.gov (United States)

    Smither, Sophie J; Weller, Simon A; Phelps, Amanda; Eastaugh, Lin; Ngugi, Sarah; O'Brien, Lyn M; Steward, Jackie; Lonsdale, Steve G; Lever, Mark S

    2015-10-01

    Rapid inactivation of Ebola virus (EBOV) is crucial for high-throughput testing of clinical samples in low-resource, outbreak scenarios. The EBOV inactivation efficacy of Buffer AVL (Qiagen) was tested against marmoset serum (EBOV concentration of 1 × 10(8) 50% tissue culture infective dose per milliliter [TCID50 · ml(-1)]) and murine blood (EBOV concentration of 1 × 10(7) TCID50 · ml(-1)) at 4:1 vol/vol buffer/sample ratios. Posttreatment cell culture and enzyme-linked immunosorbent assay (ELISA) analysis indicated that treatment with Buffer AVL did not inactivate EBOV in 67% of samples, indicating that Buffer AVL, which is designed for RNA extraction and not virus inactivation, cannot be guaranteed to inactivate EBOV in diagnostic samples. Murine blood samples treated with ethanol (4:1 [vol/vol] ethanol/sample) or heat (60°C for 15 min) also showed no viral inactivation in 67% or 100% of samples, respectively. However, combined Buffer AVL and ethanol or Buffer AVL and heat treatments showed total viral inactivation in 100% of samples tested. The Buffer AVL plus ethanol and Buffer AVL plus heat treatments were also shown not to affect the extraction of PCR quality RNA from EBOV-spiked murine blood samples. © Crown copyright 2015.

  3. Representing Sudden Shifts in Intensive Dyadic Interaction Data Using Differential Equation Models with Regime Switching.

    Science.gov (United States)

    Chow, Sy-Miin; Ou, Lu; Ciptadi, Arridhana; Prince, Emily B; You, Dongjun; Hunter, Michael D; Rehg, James M; Rozga, Agata; Messinger, Daniel S

    2018-06-01

    A growing number of social scientists have turned to differential equations as a tool for capturing the dynamic interdependence among a system of variables. Current tools for fitting differential equation models do not provide a straightforward mechanism for diagnosing evidence for qualitative shifts in dynamics, nor do they provide ways of identifying the timing and possible determinants of such shifts. In this paper, we discuss regime-switching differential equation models, a novel modeling framework for representing abrupt changes in a system of differential equation models. Estimation was performed by combining the Kim filter (Kim and Nelson State-space models with regime switching: classical and Gibbs-sampling approaches with applications, MIT Press, Cambridge, 1999) and a numerical differential equation solver that can handle both ordinary and stochastic differential equations. The proposed approach was motivated by the need to represent discrete shifts in the movement dynamics of [Formula: see text] mother-infant dyads during the Strange Situation Procedure (SSP), a behavioral assessment where the infant is separated from and reunited with the mother twice. We illustrate the utility of a novel regime-switching differential equation model in representing children's tendency to exhibit shifts between the goal of staying close to their mothers and intermittent interest in moving away from their mothers to explore the room during the SSP. Results from empirical model fitting were supplemented with a Monte Carlo simulation study to evaluate the use of information criterion measures to diagnose sudden shifts in dynamics.

  4. Animated-simulation modeling facilitates clinical-process costing.

    Science.gov (United States)

    Zelman, W N; Glick, N D; Blackmore, C C

    2001-09-01

    Traditionally, the finance department has assumed responsibility for assessing process costs in healthcare organizations. To enhance process-improvement efforts, however, many healthcare providers need to include clinical staff in process cost analysis. Although clinical staff often use electronic spreadsheets to model the cost of specific processes, PC-based animated-simulation tools offer two major advantages over spreadsheets: they allow clinicians to interact more easily with the costing model so that it more closely represents the process being modeled, and they represent cost output as a cost range rather than as a single cost estimate, thereby providing more useful information for decision making.

  5. Towards an integrated model of floodplain hydrology representing feedbacks and anthropogenic effects

    Science.gov (United States)

    Andreadis, K.; Schumann, G.; Voisin, N.; O'Loughlin, F.; Tesfa, T. K.; Bates, P.

    2017-12-01

    The exchange of water between hillslopes, river channels and floodplain can be quite complex and the difficulty in capturing the mechanisms behind it is exacerbated by the impact of human activities such as irrigation and reservoir operations. Although there has been a vast body of work on modeling hydrological processes, most of the resulting models have been limited with regards to aspects of the coupled human-natural system. For example, hydrologic models that represent processes such as evapotranspiration, infiltration, interception and groundwater dynamics often neglect anthropogenic effects or do not adequately represent the inherently two-dimensional floodplain flow. We present an integrated modeling framework that is comprised of the Variable Infiltration Capacity (VIC) hydrology model, the LISFLOOD-FP hydrodynamic model, and the Water resources Management (WM) model. The VIC model solves the energy and water balance over a gridded domain and simulates a number of hydrologic features such as snow, frozen soils, lakes and wetlands, while also representing irrigation demand from cropland areas. LISFLOOD-FP solves an approximation of the Saint-Venant equations to efficiently simulate flow in river channels and the floodplain. The implementation of WM accommodates a variety of operating rules in reservoirs and withdrawals due to consumptive demands, allowing the successful simulation of regulated flow. The models are coupled so as to allow feedbacks between their corresponding processes, therefore providing the ability to test different hypotheses about the floodplain hydrology of large-scale basins. We test this integrated framework over the Zambezi River basin by simulating its hydrology from 2000-2010, and evaluate the results against remotely sensed observations. Finally, we examine the sensitivity of streamflow and water inundation to changes in reservoir operations, precipitation and temperature.

  6. Representing Degree Distributions, Clustering, and Homophily in Social Networks With Latent Cluster Random Effects Models.

    Science.gov (United States)

    Krivitsky, Pavel N; Handcock, Mark S; Raftery, Adrian E; Hoff, Peter D

    2009-07-01

    Social network data often involve transitivity, homophily on observed attributes, clustering, and heterogeneity of actor degrees. We propose a latent cluster random effects model to represent all of these features, and we describe a Bayesian estimation method for it. The model is applicable to both binary and non-binary network data. We illustrate the model using two real datasets. We also apply it to two simulated network datasets with the same, highly skewed, degree distribution, but very different network behavior: one unstructured and the other with transitivity and clustering. Models based on degree distributions, such as scale-free, preferential attachment and power-law models, cannot distinguish between these very different situations, but our model does.

  7. Representing Operational Knowledge of PWR Plant by Using Multilevel Flow Modelling

    DEFF Research Database (Denmark)

    Zhang, Xinxin; Lind, Morten; Jørgensen, Sten Bay

    2014-01-01

    situation and support operational decisions. This paper will provide a general MFM model of the primary side in a standard Westinghouse Pressurized Water Reactor ( PWR ) system including sub - systems of Reactor Coolant System, Rod Control System, Chemical and Volume Control System, emergency heat removal......The aim of this paper is to explore the capability of representing operational knowledge by using Multilevel Flow Modelling ( MFM ) methodology. The paper demonstrate s how the operational knowledge can be inserted into the MFM models and be used to evaluate the plant state, identify the current...... systems. And the sub - systems’ functions will be decomposed into sub - models according to different operational situations. An operational model will be developed based on the operating procedure by using MFM symbols and this model can be used to implement coordination rules for organize the utilizati...

  8. Representing macropore flow at the catchment scale: a comparative modeling study

    Science.gov (United States)

    Liu, D.; Li, H. Y.; Tian, F.; Leung, L. R.

    2017-12-01

    Macropore flow is an important hydrological process that generally enhances the soil infiltration capacity and velocity of subsurface water. Up till now, macropore flow is mostly simulated with high-resolution models. One possible drawback of this modeling approach is the difficulty to effectively represent the overall typology and connectivity of the macropore networks. We hypothesize that modeling macropore flow directly at the catchment scale may be complementary to the existing modeling strategy and offer some new insights. Tsinghua Representative Elementary Watershed model (THREW model) is a semi-distributed hydrology model, where the fundamental building blocks are representative elementary watersheds (REW) linked by the river channel network. In THREW, all the hydrological processes are described with constitutive relationships established directly at the REW level, i.e., catchment scale. In this study, the constitutive relationship of macropore flow drainage is established as part of THREW. The enhanced THREW model is then applied at two catchments with deep soils but distinct climates, the humid Asu catchment in the Amazon River basin, and the arid Wei catchment in the Yellow River basin. The Asu catchment has an area of 12.43km2 with mean annual precipitation of 2442mm. The larger Wei catchment has an area of 24800km2 but with mean annual precipitation of only 512mm. The rainfall-runoff processes are simulated at a hourly time step from 2002 to 2005 in the Asu catchment and from 2001 to 2012 in the Wei catchment. The role of macropore flow on the catchment hydrology will be analyzed comparatively over the Asu and Wei catchments against the observed streamflow, evapotranspiration and other auxiliary data.

  9. Using a Mechanistic Reactive Transport Model to Represent Soil Organic Matter Dynamics and Climate Sensitivity

    Science.gov (United States)

    Guerry, N.; Riley, W. J.; Maggi, F.; Torn, M. S.; Kleber, M.

    2011-12-01

    The nature of long term Soil Organic Matter (SOM) dynamics is uncertain and the mechanisms involved are crudely represented in site, regional, and global models. Recent work challenging the paradigm that SOM is stabilized because of its sequential transformations to more intrinsically recalcitrant compounds motivated us to develop a mechanistic modeling framework that can be used to test hypotheses of SOM dynamics. We developed our C cycling model in TOUGHREACT, an established 3-dimensional reactive transport solver that accounts for multiple phases (aqueous, gaseous, sorbed), multiple species, advection and diffusion, and multiple microbial populations. Energy and mass exchange through the soil boundaries are accounted for via ground heat flux, rainfall, C sources (e.g., exudation, woody, leaf, root litter) and C losses (e.g., CO2 emissions and DOC deep percolation). SOM is categorized according to the various types of compounds commonly found in the above mentioned C sources and microbial byproducts, including poly- and monosaccharides, lignin, amino compounds, organic acids, nucleic acids, lipids, and phenols. Each of these compounds is accounted for by one or more representative species in the model. A reaction network was developed to describe the microbially-mediated processes and chemical interactions of these species, including depolymerization, microbial assimilation, respiration and deposition of byproducts, and incorporation of dead biomass into SOM stocks. Enzymatic reactions are characterized by Michaelis-Menten kinetics, with maximum reaction rates determined by the species' O/C ratio. Microbial activity is further regulated by soil moisture content, O2 availability, pH, and temperature. For the initial set of simulations, literature values were used to constrain microbial Monod parameters, Michaelis-Menten parameters, sorption parameters, physical protection, partitioning of microbial byproducts, and partitioning of litter inputs, although there is

  10. Can Geostatistical Models Represent Nature's Variability? An Analysis Using Flume Experiments

    Science.gov (United States)

    Scheidt, C.; Fernandes, A. M.; Paola, C.; Caers, J.

    2015-12-01

    The lack of understanding in the Earth's geological and physical processes governing sediment deposition render subsurface modeling subject to large uncertainty. Geostatistics is often used to model uncertainty because of its capability to stochastically generate spatially varying realizations of the subsurface. These methods can generate a range of realizations of a given pattern - but how representative are these of the full natural variability? And how can we identify the minimum set of images that represent this natural variability? Here we use this minimum set to define the geostatistical prior model: a set of training images that represent the range of patterns generated by autogenic variability in the sedimentary environment under study. The proper definition of the prior model is essential in capturing the variability of the depositional patterns. This work starts with a set of overhead images from an experimental basin that showed ongoing autogenic variability. We use the images to analyze the essential characteristics of this suite of patterns. In particular, our goal is to define a prior model (a minimal set of selected training images) such that geostatistical algorithms, when applied to this set, can reproduce the full measured variability. A necessary prerequisite is to define a measure of variability. In this study, we measure variability using a dissimilarity distance between the images. The distance indicates whether two snapshots contain similar depositional patterns. To reproduce the variability in the images, we apply an MPS algorithm to the set of selected snapshots of the sedimentary basin that serve as training images. The training images are chosen from among the initial set by using the distance measure to ensure that only dissimilar images are chosen. Preliminary investigations show that MPS can reproduce fairly accurately the natural variability of the experimental depositional system. Furthermore, the selected training images provide

  11. Qualitative and quantitative examination of the performance of regional air quality models representing different modeling approaches

    International Nuclear Information System (INIS)

    Bhumralkar, C.M.; Ludwig, F.L.; Shannon, J.D.; McNaughton, D.

    1985-04-01

    The calculations of three different air quality models were compared with the best available observations. The comparisons were made without calibrating the models to improve agreement with the observations. Model performance was poor for short averaging times (less than 24 hours). Some of the poor performance can be traced to errors in the input meteorological fields, but error exist on all levels. It should be noted that these models were not originally designed for treating short-term episodes. For short-term episodes, much of the variance in the data can arise from small spatial scale features that tend to be averaged out over longer periods. These small spatial scale features cannot be resolved with the coarse grids that are used for the meteorological and emissions inputs. Thus, it is not surprising that the models performed for the longer averaging times. The models compared were RTM-II, ENAMAP-2 and ACID. (17 refs., 5 figs., 4 tabs

  12. Modeling and simulation of different and representative engineering problems using Network Simulation Method.

    Science.gov (United States)

    Sánchez-Pérez, J F; Marín, F; Morales, J L; Cánovas, M; Alhama, F

    2018-01-01

    Mathematical models simulating different and representative engineering problem, atomic dry friction, the moving front problems and elastic and solid mechanics are presented in the form of a set of non-linear, coupled or not coupled differential equations. For different parameters values that influence the solution, the problem is numerically solved by the network method, which provides all the variables of the problems. Although the model is extremely sensitive to the above parameters, no assumptions are considered as regards the linearization of the variables. The design of the models, which are run on standard electrical circuit simulation software, is explained in detail. The network model results are compared with common numerical methods or experimental data, published in the scientific literature, to show the reliability of the model.

  13. Modeling and simulation of different and representative engineering problems using Network Simulation Method

    Science.gov (United States)

    2018-01-01

    Mathematical models simulating different and representative engineering problem, atomic dry friction, the moving front problems and elastic and solid mechanics are presented in the form of a set of non-linear, coupled or not coupled differential equations. For different parameters values that influence the solution, the problem is numerically solved by the network method, which provides all the variables of the problems. Although the model is extremely sensitive to the above parameters, no assumptions are considered as regards the linearization of the variables. The design of the models, which are run on standard electrical circuit simulation software, is explained in detail. The network model results are compared with common numerical methods or experimental data, published in the scientific literature, to show the reliability of the model. PMID:29518121

  14. Conceptual Models and Guidelines for Clinical Assessment of Financial Capacity.

    Science.gov (United States)

    Marson, Daniel

    2016-09-01

    The ability to manage financial affairs is a life skill of critical importance, and neuropsychologists are increasingly asked to assess financial capacity across a variety of settings. Sound clinical assessment of financial capacity requires knowledge and appreciation of applicable clinical conceptual models and principles. However, the literature has presented relatively little conceptual guidance for clinicians concerning financial capacity and its assessment. This article seeks to address this gap. The article presents six clinical models of financial capacity : (1) the early gerontological IADL model of Lawton, (2) the clinical skills model and (3) related cognitive psychological model developed by Marson and colleagues, (4) a financial decision-making model adapting earlier decisional capacity work of Appelbaum and Grisso, (5) a person-centered model of financial decision-making developed by Lichtenberg and colleagues, and (6) a recent model of financial capacity in the real world developed through the Institute of Medicine. Accompanying presentation of the models is discussion of conceptual and practical perspectives they represent for clinician assessment. Based on the models, the article concludes by presenting a series of conceptually oriented guidelines for clinical assessment of financial capacity. In summary, sound assessment of financial capacity requires knowledge and appreciation of clinical conceptual models and principles. Awareness of such models, principles and guidelines will strengthen and advance clinical assessment of financial capacity. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Can objective measurements of the nasal form and function represent the clinical picture in unilateral cleft lip and palate?

    Science.gov (United States)

    Peroz, Roshan; Holmström, Mats; Mani, Maria

    2017-05-01

    The present study aimed to evaluate the potential correlations between objective measurements of nasal function and self-assessed nasal symptoms or clinical findings at nasal examination among adults treated for unilateral cleft lip and palate (UCLP), respectively. All UCLP patients born between 1960 and 1987 (n = 109) treated at a tertiary referring center were invited. Participation rate was 76% (n = 83) at a mean of 37 years after the initial surgery. All participants completed the same study protocol including acoustic rhinometry (AR), rhinomanometry (RM), anterior rhinoscopy, and questionnaires regarding self-experienced nasal symptoms. A reduced volume of the anterior nasal cavity on the operated side (measured by AR) correlated to an expressed wish by the patient to change the function of the nose. A similar correlation was seen for the minimal cross-sectional area of anterior nasal cavity on the operated side. Furthermore, correlations were found between smaller volume and area of nasal cavity and a greater frequency of nasal obstruction. No further correlations were found. Objective measurements partly correlate to the clinical picture among adults treated for UCLP. However, these need to be combined with findings at clinical examination and patient self-assessment to represent the complete clinical picture. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  16. Technical note: Representing glacier geometry changes in a semi-distributed hydrological model

    Directory of Open Access Journals (Sweden)

    J. Seibert

    2018-04-01

    Full Text Available Glaciers play an important role in high-mountain hydrology. While changing glacier areas are considered of highest importance for the understanding of future changes in runoff, glaciers are often only poorly represented in hydrological models. Most importantly, the direct coupling between the simulated glacier mass balances and changing glacier areas needs feasible solutions. The use of a complex glacier model is often not possible due to data and computational limitations. The Δh parameterization is a simple approach to consider the spatial variation of glacier thickness and area changes. Here, we describe a conceptual implementation of the Δh parameterization in the semi-distributed hydrological model HBV-light, which also allows for the representation of glacier advance phases and for comparison between the different versions of the implementation. The coupled glacio-hydrological simulation approach, which could also be implemented in many other semi-distributed hydrological models, is illustrated based on an example application.

  17. Clinical and economic outcomes among hospitalized patients with acute coronary syndrome: an analysis of a national representative Medicare population.

    Science.gov (United States)

    Chen, Shih-Yin; Crivera, Concetta; Stokes, Michael; Boulanger, Luke; Schein, Jeffrey

    2013-01-01

    To evaluate the clinical and economic burden of acute coronary syndrome (ACS), a common cardiovascular illness, in the Medicare population. Data from the Medicare Current Beneficiary Survey were analyzed. Patients with incident hospitalization for ACS without similar events during the 6 months prior were included. Outcomes evaluated included inpatient mortality, 30-day mortality and readmission, subsequent hospitalization events, and total direct health care costs. Sample population weights were applied, accounting for multistage sampling design to obtain nationally representative estimates for the US Medicare population. Between March 1, 2002 and December 31, 2006, we identified 795 incident ACS patients (mean age 76 years; 49% male) representing 2,542,211 Medicare beneficiaries. The inpatient mortality rate was 9.71% and the 30-day mortality ranged from 10.96% to 13.93%. The 30-day readmission rate for surviving patients was 18.56% for all causes and 17.90% for cardiovascular disease (CVD)-related diagnoses. The incidence of death since admission was 309 cases per 1000 person-years. Among patients discharged alive, the incidence was 197 for death, 847 for CVD-related admission, and 906 for all-cause admission. During the year when the ACS event occurred, mean annual total direct health care costs per person were US$50,458, with more than half attributable to inpatient hospitalization ($27,609). In this national representative Medicare population, we found a substantial clinical and economic burden for ACS. These findings suggest a continuing unmet medical need for more effective management of patients with ACS. The continuous burden underscores the importance of development of new interventions and/or strategies to improve long-term outcomes.

  18. Clinical and economic outcomes among hospitalized patients with acute coronary syndrome: an analysis of a national representative Medicare population

    Directory of Open Access Journals (Sweden)

    Chen SY

    2013-05-01

    Full Text Available Shih-Yin Chen,1 Concetta Crivera,2 Michael Stokes,1 Luke Boulanger,1 Jeffrey Schein2 1United BioSource Corporation, Lexington, MA, USA; 2Janssen Scientific Affairs, LLC, Raritan, NJ, USA Objective: To evaluate the clinical and economic burden of acute coronary syndrome (ACS, a common cardiovascular illness, in the Medicare population. Methods: Data from the Medicare Current Beneficiary Survey were analyzed. Patients with incident hospitalization for ACS without similar events during the 6 months prior were included. Outcomes evaluated included inpatient mortality, 30-day mortality and readmission, subsequent hospitalization events, and total direct health care costs. Sample population weights were applied, accounting for multistage sampling design to obtain nationally representative estimates for the US Medicare population. Results: Between March 1, 2002 and December 31, 2006, we identified 795 incident ACS patients (mean age 76 years; 49% male representing 2,542,211 Medicare beneficiaries. The inpatient mortality rate was 9.71% and the 30-day mortality ranged from 10.96% to 13.93%. The 30-day readmission rate for surviving patients was 18.56% for all causes and 17.90% for cardiovascular disease (CVD-related diagnoses. The incidence of death since admission was 309 cases per 1000 person–years. Among patients discharged alive, the incidence was 197 for death, 847 for CVD-related admission, and 906 for all-cause admission. During the year when the ACS event occurred, mean annual total direct health care costs per person were US$50,458, with more than half attributable to inpatient hospitalization ($27,609. Conclusion: In this national representative Medicare population, we found a substantial clinical and economic burden for ACS. These findings suggest a continuing unmet medical need for more effective management of patients with ACS. The continuous burden underscores the importance of development of new interventions and/or strategies to

  19. Data Structure Analysis to Represent Basic Models of Finite State Automation

    Directory of Open Access Journals (Sweden)

    V. V. Gurenko

    2015-01-01

    Full Text Available Complex system engineering based on the automaton models requires a reasoned data structure selection to implement them. The problem of automaton representation and data structure selection to be used in it has been understudied. Arbitrary data structure selection for automaton model software implementation leads to unnecessary computational burden and reduces the developed system efficiency. This article proposes an approach to the reasoned selection of data structures to represent finite algoristic automaton basic models and gives practical considerations based on it.Static and dynamic data structures are proposed for three main ways to assign Mealy and Moore automatons: a transition table, a matrix of coupling and a transition graph. A thirddimensional array, a rectangular matrix and a matrix of lists are the static structures. Dynamic structures are list-oriented structures: two-level and three-level Ayliff vectors and a multi-linked list. These structures allow us to store all required information about finite state automaton model components - characteristic set cardinalities and data of transition and output functions.A criterion system is proposed for data structure comparative evaluation in virtue of algorithmic features of automata theory problems. The criteria focused on capacitive and time computational complexity of operations performed in tasks such as equivalent automaton conversions, proving of automaton equivalence and isomorphism, and automaton minimization.A data structure comparative analysis based on the criterion system has done for both static and dynamic type. The analysis showed advantages of the third-dimensional array, matrix and two-level Ayliff vector. These are structures that assign automaton by transition table. For these structures an experiment was done to measure the execution time of automation operations included in criterion system.The analysis of experiment results showed that a dynamic structure - two

  20. Ontology modeling for generation of clinical pathways

    Directory of Open Access Journals (Sweden)

    Jasmine Tehrani

    2012-12-01

    Full Text Available Purpose: Increasing costs of health care, fuelled by demand for high quality, cost-effective healthcare has drove hospitals to streamline their patient care delivery systems. One such systematic approach is the adaptation of Clinical Pathways (CP as a tool to increase the quality of healthcare delivery. However, most organizations still rely on are paper-based pathway guidelines or specifications, which have limitations in process management and as a result can influence patient safety outcomes. In this paper, we present a method for generating clinical pathways based on organizational semiotics by capturing knowledge from syntactic, semantic and pragmatic to social level. Design/methodology/approach: The proposed modeling approach to generation of CPs adopts organizational semiotics and enables the generation of semantically rich representation of CP knowledge. Semantic Analysis Method (SAM is applied to explicitly represent the semantics of the concepts, their relationships and patterns of behavior in terms of an ontology chart. Norm Analysis Method (NAM is adopted to identify and formally specify patterns of behavior and rules that govern the actions identified on the ontology chart. Information collected during semantic and norm analysis is integrated to guide the generation of CPs using best practice represented in BPMN thus enabling the automation of CP. Findings: This research confirms the necessity of taking into consideration social aspects in designing information systems and automating CP. The complexity of healthcare processes can be best tackled by analyzing stakeholders, which we treat as social agents, their goals and patterns of action within the agent network. Originality/value: The current modeling methods describe CPs from a structural aspect comprising activities, properties and interrelationships. However, these methods lack a mechanism to describe possible patterns of human behavior and the conditions under which the

  1. Regional climate models' performance in representing precipitation and temperature over selected Mediterranean areas

    Directory of Open Access Journals (Sweden)

    R. Deidda

    2013-12-01

    Full Text Available This paper discusses the relative performance of several climate models in providing reliable forcing for hydrological modeling in six representative catchments in the Mediterranean region. We consider 14 Regional Climate Models (RCMs, from the EU-FP6 ENSEMBLES project, run for the A1B emission scenario on a common 0.22° (about 24 km rotated grid over Europe and the Mediterranean region. In the validation period (1951 to 2010 we consider daily precipitation and surface temperatures from the observed data fields (E-OBS data set, available from the ENSEMBLES project and the data providers in the ECA&D project. Our primary objective is to rank the 14 RCMs for each catchment and select the four best-performing ones to use as common forcing for hydrological models in the six Mediterranean basins considered in the EU-FP7 CLIMB project. Using a common suite of four RCMs for all studied catchments reduces the (epistemic uncertainty when evaluating trends and climate change impacts in the 21st century. We present and discuss the validation setting, as well as the obtained results and, in some detail, the difficulties we experienced when processing the data. In doing so we also provide useful information and advice for researchers not directly involved in climate modeling, but interested in the use of climate model outputs for hydrological modeling and, more generally, climate change impact studies in the Mediterranean region.

  2. Structure-based Markov random field model for representing evolutionary constraints on functional sites.

    Science.gov (United States)

    Jeong, Chan-Seok; Kim, Dongsup

    2016-02-24

    Elucidating the cooperative mechanism of interconnected residues is an important component toward understanding the biological function of a protein. Coevolution analysis has been developed to model the coevolutionary information reflecting structural and functional constraints. Recently, several methods have been developed based on a probabilistic graphical model called the Markov random field (MRF), which have led to significant improvements for coevolution analysis; however, thus far, the performance of these models has mainly been assessed by focusing on the aspect of protein structure. In this study, we built an MRF model whose graphical topology is determined by the residue proximity in the protein structure, and derived a novel positional coevolution estimate utilizing the node weight of the MRF model. This structure-based MRF method was evaluated for three data sets, each of which annotates catalytic site, allosteric site, and comprehensively determined functional site information. We demonstrate that the structure-based MRF architecture can encode the evolutionary information associated with biological function. Furthermore, we show that the node weight can more accurately represent positional coevolution information compared to the edge weight. Lastly, we demonstrate that the structure-based MRF model can be reliably built with only a few aligned sequences in linear time. The results show that adoption of a structure-based architecture could be an acceptable approximation for coevolution modeling with efficient computation complexity.

  3. Representing environment-induced helix-coil transitions in a coarse grained peptide model

    Science.gov (United States)

    Dalgicdir, Cahit; Globisch, Christoph; Sayar, Mehmet; Peter, Christine

    2016-10-01

    Coarse grained (CG) models are widely used in studying peptide self-assembly and nanostructure formation. One of the recurrent challenges in CG modeling is the problem of limited transferability, for example to different thermodynamic state points and system compositions. Understanding transferability is generally a prerequisite to knowing for which problems a model can be reliably used and predictive. For peptides, one crucial transferability question is whether a model reproduces the molecule's conformational response to a change in its molecular environment. This is of particular importance since CG peptide models often have to resort to auxiliary interactions that aid secondary structure formation. Such interactions take care of properties of the real system that are per se lost in the coarse graining process such as dihedral-angle correlations along the backbone or backbone hydrogen bonding. These auxiliary interactions may then easily overstabilize certain conformational propensities and therefore destroy the ability of the model to respond to stimuli and environment changes, i.e. they impede transferability. In the present paper we have investigated a short peptide with amphiphilic EALA repeats which undergoes conformational transitions between a disordered and a helical state upon a change in pH value or due to the presence of a soft apolar/polar interface. We designed a base CG peptide model that does not carry a specific (backbone) bias towards a secondary structure. This base model was combined with two typical approaches of ensuring secondary structure formation, namely a C α -C α -C α -C α pseudodihedral angle potential or a virtual site interaction that mimics hydrogen bonding. We have investigated the ability of the two resulting CG models to represent the environment-induced conformational changes in the helix-coil equilibrium of EALA. We show that with both approaches a CG peptide model can be obtained that is environment-transferable and that

  4. LES of n-Dodecane Spray Combustion Using a Multiple Representative Interactive Flamelets Model

    Directory of Open Access Journals (Sweden)

    Davidovic Marco

    2017-09-01

    Full Text Available A single-hole n-dodecane spray flame is studied in a Large-Eddy Simulation (LES framework under Diesel-relevant conditions using a Multiple Representative Interactive Flamelets (MRIF combustion model. Diesel spray combustion is strongly affected by the mixture formation process, which is dominated by several physical processes such as the flow within the injector, break-up of the liquid fuel jet, evaporation and turbulent mixing with the surrounding gas. While the effects of nozzle-internal flow and primary breakup are captured within tuned model parameters in traditional Lagrangian spray models, an alternative approach is applied in this study, where the initial droplet conditions and primary fuel jet breakup are modeled based on results from highly resolved multiphase simulations with resolved interface. A highly reduced chemical mechanism consisting of 57 species and 217 reactions has been developed for n-dodecane achiving a good computational performance at solving the chemical reactions. The MRIF model, which has demonstrated its capability of capturing combustion and pollutant formation under typical Diesel conditions in Reynolds-Averaged Navier-Stokes (RANS simulations is extended for the application in LES. In the standard RIF combustion model, representative chemistry conditioned on mixture fraction is solved interactively with the flow. Subfilter-scale mixing is modeled by the scalar dissipation rate. While the standard RIF model only includes temporal changes of the scalar dissipation rate, the spatial distribution can be accounted for by extending the model to multiple flamelets, which also enables the possibility of capturing different fuel residence times. Overall, the model shows good agreement with experimental data regarding both, low and high temperature combustion characteristics. It is shown that the ignition process and pollutant formation are affected by turbulent mixing. First, a cool flame is initiated at approximately

  5. A Global Data Analysis for Representing Sediment and Particulate Organic Carbon Yield in Earth System Models

    Science.gov (United States)

    Tan, Zeli; Leung, L. Ruby; Li, Hongyi; Tesfa, Teklu; Vanmaercke, Matthias; Poesen, Jean; Zhang, Xuesong; Lu, Hui; Hartmann, Jens

    2017-12-01

    Although sediment yield (SY) from water erosion is ubiquitous and its environmental consequences are well recognized, its impacts on the global carbon cycle remain largely uncertain. This knowledge gap is partly due to the lack of soil erosion modeling in Earth System Models (ESMs), which are important tools used to understand the global carbon cycle and explore its changes. This study analyzed sediment and particulate organic carbon yield (CY) data from 1,081 and 38 small catchments (0.1-200 km2), respectively, in different environments across the globe. Using multiple statistical analysis techniques, we explored environmental factors and hydrological processes important for SY and CY modeling in ESMs. Our results show clear correlations of high SY with traditional agriculture, seismicity and heavy storms, as well as strong correlations between SY and annual peak runoff. These highlight the potential limitation of SY models that represent only interrill and rill erosion because shallow overland flow and rill flow have limited transport capacity due to their hydraulic geometry to produce high SY. Further, our results suggest that SY modeling in ESMs should be implemented at the event scale to produce the catastrophic mass transport during episodic events. Several environmental factors such as seismicity and land management that are often not considered in current catchment-scale SY models can be important in controlling global SY. Our analyses show that SY is likely the primary control on CY in small catchments and a statistically significant empirical relationship is established to calculate SY and CY jointly in ESMs.

  6. A transferable coarse-grained model for diphenylalanine: How to represent an environment driven conformational transition

    Science.gov (United States)

    Dalgicdir, Cahit; Sensoy, Ozge; Peter, Christine; Sayar, Mehmet

    2013-12-01

    One of the major challenges in the development of coarse grained (CG) simulation models that aim at biomolecular structure formation processes is the correct representation of an environment-driven conformational change, for example, a folding/unfolding event upon interaction with an interface or upon aggregation. In the present study, we investigate this transferability challenge for a CG model using the example of diphenylalanine. This dipeptide displays a transition from a trans-like to a cis-like conformation upon aggregation as well as upon transfer from bulk water to the cyclohexane/water interface. Here, we show that one can construct a single CG model that can reproduce both the bulk and interface conformational behavior and the segregation between hydrophobic/hydrophilic medium. While the general strategy to obtain nonbonded interactions in the present CG model is to reproduce solvation free energies of small molecules representing the CG beads in the respective solvents, the success of the model strongly depends on nontrivial decisions one has to make to capture the delicate balance between the bonded and nonbonded interactions. In particular, we found that the peptide's conformational behavior is qualitatively affected by the cyclohexane/water interaction potential, an interaction that does not directly involve the peptide at all but merely influences the properties of the hydrophobic/hydrophilic interface. Furthermore, we show that a small modification to improve the structural/conformational properties of the CG model could dramatically alter the thermodynamic properties.

  7. The ability of current micro-velocity models to represent center-limb line profiles

    International Nuclear Information System (INIS)

    Evans, J.C.; Testerman, L.

    1975-01-01

    Results are presented on the ability of microturbulences, LTE line formation and a homogeneous thermal model to realistically represent the center-limb variation of temporally and spacially averaged solar line profiles. Three somewhat similar semi-empirical thermal models have been used in combination with five current microturbulence models which cover the gamut of homogeneous-isotropic to nonhomogeneous-anisotropic. From high resolution photoelectric data for (lambdalambda 5000-6000 at five μ-values(1,0.63,0.4,0.25,0.16) obtained at KPNO, were selected 17 Fe I and 5 Fe II line profiles to be unblended and symmetrized for study. An iterative scheme has been developed to calculate theoretical profiles for the various combination of models and compare them to the observed profile using the abundance at each limb position and the magnitude of the pressure broadening at the center of the disc as parameters. It was found that a microturbulence model, for which the radial and tangential components increase into deeper layers with xisub(tan)>xisub(rad), produces a reasonable good center-limb fit for lines less than 100mA. However for lines stronger than 140mA, microturbulence models with no depth dependence produce the best match between theory and observation. Thus there is reason to question the uniqueness of the microturbulence concept. (Auth.)

  8. A transferable coarse-grained model for diphenylalanine: How to represent an environment driven conformational transition

    International Nuclear Information System (INIS)

    Dalgicdir, Cahit; Sensoy, Ozge; Sayar, Mehmet; Peter, Christine

    2013-01-01

    One of the major challenges in the development of coarse grained (CG) simulation models that aim at biomolecular structure formation processes is the correct representation of an environment-driven conformational change, for example, a folding/unfolding event upon interaction with an interface or upon aggregation. In the present study, we investigate this transferability challenge for a CG model using the example of diphenylalanine. This dipeptide displays a transition from a trans-like to a cis-like conformation upon aggregation as well as upon transfer from bulk water to the cyclohexane/water interface. Here, we show that one can construct a single CG model that can reproduce both the bulk and interface conformational behavior and the segregation between hydrophobic/hydrophilic medium. While the general strategy to obtain nonbonded interactions in the present CG model is to reproduce solvation free energies of small molecules representing the CG beads in the respective solvents, the success of the model strongly depends on nontrivial decisions one has to make to capture the delicate balance between the bonded and nonbonded interactions. In particular, we found that the peptide's conformational behavior is qualitatively affected by the cyclohexane/water interaction potential, an interaction that does not directly involve the peptide at all but merely influences the properties of the hydrophobic/hydrophilic interface. Furthermore, we show that a small modification to improve the structural/conformational properties of the CG model could dramatically alter the thermodynamic properties

  9. A transferable coarse-grained model for diphenylalanine: How to represent an environment driven conformational transition

    Energy Technology Data Exchange (ETDEWEB)

    Dalgicdir, Cahit; Sensoy, Ozge; Sayar, Mehmet, E-mail: msayar@ku.edu.tr [College of Engineering, Koç University, 34450 Istanbul (Turkey); Peter, Christine [Max Planck Institute for Polymer Research, 55128 Mainz (Germany); Department of Chemistry, University of Konstanz, 78547 Konstanz (Germany)

    2013-12-21

    One of the major challenges in the development of coarse grained (CG) simulation models that aim at biomolecular structure formation processes is the correct representation of an environment-driven conformational change, for example, a folding/unfolding event upon interaction with an interface or upon aggregation. In the present study, we investigate this transferability challenge for a CG model using the example of diphenylalanine. This dipeptide displays a transition from a trans-like to a cis-like conformation upon aggregation as well as upon transfer from bulk water to the cyclohexane/water interface. Here, we show that one can construct a single CG model that can reproduce both the bulk and interface conformational behavior and the segregation between hydrophobic/hydrophilic medium. While the general strategy to obtain nonbonded interactions in the present CG model is to reproduce solvation free energies of small molecules representing the CG beads in the respective solvents, the success of the model strongly depends on nontrivial decisions one has to make to capture the delicate balance between the bonded and nonbonded interactions. In particular, we found that the peptide's conformational behavior is qualitatively affected by the cyclohexane/water interaction potential, an interaction that does not directly involve the peptide at all but merely influences the properties of the hydrophobic/hydrophilic interface. Furthermore, we show that a small modification to improve the structural/conformational properties of the CG model could dramatically alter the thermodynamic properties.

  10. A Global Data Analysis for Representing Sediment and Particulate Organic Carbon Yield in Earth System Models

    Energy Technology Data Exchange (ETDEWEB)

    Tan, Zeli [Pacific Northwest National Laboratory, Richland WA USA; Leung, L. Ruby [Pacific Northwest National Laboratory, Richland WA USA; Li, Hongyi [Montana State University, Bozeman MT USA; Tesfa, Teklu [Pacific Northwest National Laboratory, Richland WA USA; Vanmaercke, Matthias [Département de Géographie, Université de Liège, Liege Belgium; Poesen, Jean [Department of Earth and Environmental Sciences, Division of Geography, KU Leuven, Leuven Belgium; Zhang, Xuesong [Pacific Northwest National Laboratory, Richland WA USA; Lu, Hui [Ministry of Education Key Laboratory for Earth System Modeling, Department of Earth System Science, Tsinghua University, Beijing China; Hartmann, Jens [Institute for Geology, Center for Earth System Research and Sustainability, Universität Hamburg, Hamburg Germany

    2017-12-01

    Although sediment yield (SY) from water erosion is ubiquitous and its environmental consequences are well recognized, its impacts on the global carbon cycle remain largely uncertain. This knowledge gap is partly due to the lack of soil erosion modeling in Earth System Models (ESMs), which are important tools used to understand the global carbon cycle and explore its changes. This study analyzed sediment and particulate organic carbon yield (CY) data from 1081 and 38 small catchments (0.1-200 km27 ), respectively, in different environments across the globe. Using multiple statistical analysis techniques, we explored environmental factors and hydrological processes important for SY and CY modeling in ESMs. Our results show clear correlations of high SY with traditional agriculture, seismicity and heavy storms, as well as strong correlations between SY and annual peak runoff. These highlight the potential limitation of SY models that represent only interrill and rill erosion because shallow overland flow and rill flow have limited transport capacity due to their hydraulic geometry to produce high SY. Further, our results suggest that SY modeling in ESMs should be implemented at the event scale to produce the catastrophic mass transport during episodic events. Several environmental factors such as seismicity and land management that are often not considered in current catchment-scale SY models can be important in controlling global SY. Our analyses show that SY is likely the primary control on CY in small catchments and a statistically significant empirical relationship is established to calculate SY and CY jointly in ESMs.

  11. Comparison of surface meteorological data representativeness for the Weldon Spring transport and dispersion modeling analysis

    International Nuclear Information System (INIS)

    Lazaro, M.

    1989-06-01

    The US Department of Energy is conducting the Weldon Spring Site Remedial Action Project under the Surplus Facilities Management Program (SFMP). The major goals of the SFMP are to eliminate potential hazards to the public and the environment that associated with contamination at SFMP sites and to make surplus property available for other uses to the extent possible. This report presents the results of analysis of available meteorological data from stations near the Weldon Spring site. Data that are most representative of site conditions are needed to accurately model the transport and dispersion of air pollutants associated with remedial activities. Such modeling will assist the development of mitigative measures. 17 refs., 12 figs., 6 tabs

  12. Is the mental wellbeing of young Australians best represented by a single, multidimensional or bifactor model?

    Science.gov (United States)

    Hides, Leanne; Quinn, Catherine; Stoyanov, Stoyan; Cockshaw, Wendell; Mitchell, Tegan; Kavanagh, David J

    2016-07-30

    Internationally there is a growing interest in the mental wellbeing of young people. However, it is unclear whether mental wellbeing is best conceptualized as a general wellbeing factor or a multidimensional construct. This paper investigated whether mental wellbeing, measured by the Mental Health Continuum-Short Form (MHC-SF), is best represented by: (1) a single-factor general model; (2) a three-factor multidimensional model or (3) a combination of both (bifactor model). 2220 young Australians aged between 16 and 25 years completed an online survey including the MHC-SF and a range of other wellbeing and mental ill-health measures. Exploratory factor analysis supported a bifactor solution, comprised of a general wellbeing factor, and specific group factors of psychological, social and emotional wellbeing. Confirmatory factor analysis indicated that the bifactor model had a better fit than competing single and three-factor models. The MHC-SF total score was more strongly associated with other wellbeing and mental ill-health measures than the social, emotional or psychological subscale scores. Findings indicate that the mental wellbeing of young people is best conceptualized as an overarching latent construct (general wellbeing) to which emotional, social and psychological domains contribute. The MHC-SF total score is a valid and reliable measure of this general wellbeing factor. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Using ecosystem services to represent the environment in hydro-economic models

    Science.gov (United States)

    Momblanch, Andrea; Connor, Jeffery D.; Crossman, Neville D.; Paredes-Arquiola, Javier; Andreu, Joaquín

    2016-07-01

    Demand for water is expected to grow in line with global human population growth, but opportunities to augment supply are limited in many places due to resource limits and expected impacts of climate change. Hydro-economic models are often used to evaluate water resources management options, commonly with a goal of understanding how to maximise water use value and reduce conflicts among competing uses. The environment is now an important factor in decision making, which has resulted in its inclusion in hydro-economic models. We reviewed 95 studies applying hydro-economic models, and documented how the environment is represented in them and the methods they use to value environmental costs and benefits. We also sought out key gaps and inconsistencies in the treatment of the environment in hydro-economic models. We found that representation of environmental values of water is patchy in most applications, and there should be systematic consideration of the scope of environmental values to include and how they should be valued. We argue that the ecosystem services framework offers a systematic approach to identify the full range of environmental costs and benefits. The main challenges to more holistic representation of the environment in hydro-economic models are the current limits to understanding of ecological functions which relate physical, ecological and economic values and critical environmental thresholds; and the treatment of uncertainty.

  14. DNM3, p65 and p53 from exosomes represent potential clinical diagnosis markers for glioblastoma multiforme

    Science.gov (United States)

    Yang, Jian-kai; Song, Jian; Huo, Hao-ran; Zhao, Yin-long; Zhang, Guang-yu; Zhao, Zong-mao; Sun, Guo-zhu; Jiao, Bao-hua

    2017-01-01

    Background: Glioblastoma multiforme (GBM) is the most aggressive and deadly primary brain cancer that arises from astrocytes and classified as grade IV. Recently, exosomes have been reported as an essential mediator in diverse cancer carcinogenesis and metastasis. However, their role in GBM is still unclear. In this study, we aimed to investigate whether blood exosomes can be potential clinical diagnostic markers for GBM. Methods: We used a xenograft orthotopic mouse model to detect the differentially expressed genes in the brain and blood exosomes of original/recurrent GBM. Results: We found that recurrent GBM had stronger growth capacity and lethality than original GBM in the mouse model. A gene microarray of original tumors and blood exosomes from GBM orthotopic xenografts results showed that DNM3, p65 and CD117 expressions increased, whereas PTEN and p53 expressions decreased in both original tumors and blood exosomes. In the recurrent GBM tumor model, DNM3 and p65 showed increased expressions, whereas ST14 and p53 showed decreased expressions in tumor and blood exosomes of the recurrent GBM mouse model. Conclusion: In summary, we found that DNM3, p65 and p53 had a similar trend in brain and blood exosomes both for original and recurrent GBM, and could serve as potential clinical diagnostic markers for GBM. PMID:29449895

  15. The Importance of Representing Certain Key Vegetation Canopy Processes Explicitly in a Land Surface Model

    Science.gov (United States)

    Napoly, A.; Boone, A. A.; Martin, E.; Samuelsson, P.

    2015-12-01

    Land surface models are moving to more detailed vegetation canopy descriptions in order to better represent certain key processes, such as Carbon dynamics and snowpack evolution. Since such models are usually applied within coupled numerical weather prediction or spatially distributed hydrological models, these improvements must strike a balance between computational cost and complexity. The consequences of simplified or composite canopy approaches can be manifested in terms of increased errors with respect to soil temperatures, estimates of the diurnal cycle of the turbulent fluxes or snow canopy interception and melt. Vegetated areas and particularly forests are modeled in a quite simplified manner in the ISBA land surface model. However, continuous developments of surface processes now require a more accurate description of the canopy. A new version of the the model now includes a multi energy balance (MEB) option to explicitly represent the canopy and the forest floor. It will be shown that certain newly included processes such as the shading effect of the vegetation, the explicit heat capacity of the canopy, and the insulating effect of the forest floor turn out to be essential. A detailed study has been done for four French forested sites. It was found that the MEB option significantly improves the ground heat flux (RMSE decrease from 50W/m2 to 10W/m2 on average) and soil temperatures when compared against measurements. Also the sensible heat flux calculation was improved primarily owing to a better phasing with the solar insulation owing to a lower vegetation heat capacity. However, the total latent heat flux is less modified compared to the classical ISBA simulation since it is more related to water uptake and the formulation of the stomatal resistance (which are unchanged). Next, a benchmark over 40 Fluxnet sites (116 cumulated years) was performed and compared with results from the default composite soil-vegetation version of ISBA. The results show

  16. Can we trust climate models to realistically represent severe European windstorms?

    Science.gov (United States)

    Trzeciak, Tomasz M.; Knippertz, Peter; Owen, Jennifer S. R.

    2014-05-01

    Despite the enormous advances made in climate change research, robust projections of the position and the strength of the North Atlantic stormtrack are not yet possible. In particular with respect to damaging windstorms, this incertitude bears enormous risks to European societies and the (re)insurance industry. Previous studies have addressed the problem of climate model uncertainty through statistical comparisons of simulations of the current climate with (re-)analysis data and found that there is large disagreement between different climate models, different ensemble members of the same model and observed climatologies of intense cyclones. One weakness of such statistical evaluations lies in the difficulty to separate influences of the climate model's basic state from the influence of fast processes on the development of the most intense storms. Compensating effects between the two might conceal errors and suggest higher reliability than there really is. A possible way to separate influences of fast and slow processes in climate projections is through a "seamless" approach of hindcasting historical, severe storms with climate models started from predefined initial conditions and run in a numerical weather prediction mode on the time scale of several days. Such a cost-effective case-study approach, which draws from and expands on the concepts from the Transpose-AMIP initiative, has recently been undertaken in the SEAMSEW project at the University of Leeds funded by the AXA Research Fund. Key results from this work focusing on 20 historical storms and using different lead times and horizontal and vertical resolutions include: (a) Tracks are represented reasonably well by most hindcasts. (b) Sensitivity to vertical resolution is low. (c) There is a systematic underprediction of cyclone depth for a coarse resolution of T63, but surprisingly no systematic bias is found for higher-resolution runs using T127, showing that climate models are in fact able to represent the

  17. Harnessing Big Data to Represent 30-meter Spatial Heterogeneity in Earth System Models

    Science.gov (United States)

    Chaney, N.; Shevliakova, E.; Malyshev, S.; Van Huijgevoort, M.; Milly, C.; Sulman, B. N.

    2016-12-01

    Terrestrial land surface processes play a critical role in the Earth system; they have a profound impact on the global climate, food and energy production, freshwater resources, and biodiversity. One of the most fascinating yet challenging aspects of characterizing terrestrial ecosystems is their field-scale (˜30 m) spatial heterogeneity. It has been observed repeatedly that the water, energy, and biogeochemical cycles at multiple temporal and spatial scales have deep ties to an ecosystem's spatial structure. Current Earth system models largely disregard this important relationship leading to an inadequate representation of ecosystem dynamics. In this presentation, we will show how existing global environmental datasets can be harnessed to explicitly represent field-scale spatial heterogeneity in Earth system models. For each macroscale grid cell, these environmental data are clustered according to their field-scale soil and topographic attributes to define unique sub-grid tiles. The state-of-the-art Geophysical Fluid Dynamics Laboratory (GFDL) land model is then used to simulate these tiles and their spatial interactions via the exchange of water, energy, and nutrients along explicit topographic gradients. Using historical simulations over the contiguous United States, we will show how a robust representation of field-scale spatial heterogeneity impacts modeled ecosystem dynamics including the water, energy, and biogeochemical cycles as well as vegetation composition and distribution.

  18. Analysis of the process of representing clinical statements for decision-support applications: a comparison of openEHR archetypes and HL7 virtual medical record.

    Science.gov (United States)

    González-Ferrer, A; Peleg, M; Marcos, M; Maldonado, J A

    2016-07-01

    Delivering patient-specific decision-support based on computer-interpretable guidelines (CIGs) requires mapping CIG clinical statements (data items, clinical recommendations) into patients' data. This is most effectively done via intermediate data schemas, which enable querying the data according to the semantics of a shared standard intermediate schema. This study aims to evaluate the use of HL7 virtual medical record (vMR) and openEHR archetypes as intermediate schemas for capturing clinical statements from CIGs that are mappable to electronic health records (EHRs) containing patient data and patient-specific recommendations. Using qualitative research methods, we analyzed the encoding of ten representative clinical statements taken from two CIGs used in real decision-support systems into two health information models (openEHR archetypes and HL7 vMR instances) by four experienced informaticians. Discussion among the modelers about each case study example greatly increased our understanding of the capabilities of these standards, which we share in this educational paper. Differing in content and structure, the openEHR archetypes were found to contain a greater level of representational detail and structure while the vMR representations took fewer steps to complete. The use of openEHR in the encoding of CIG clinical statements could potentially facilitate applications other than decision-support, including intelligent data analysis and integration of additional properties of data items from existing EHRs. On the other hand, due to their smaller size and fewer details, the use of vMR potentially supports quicker mapping of EHR data into clinical statements.

  19. A Hydro-Economic Approach to Representing Water Resources Impacts in Integrated Assessment Models

    Energy Technology Data Exchange (ETDEWEB)

    Kirshen, Paul H.; Strzepek, Kenneth, M.

    2004-01-14

    Grant Number DE-FG02-98ER62665 Office of Energy Research of the U.S. Department of Energy Abstract Many Integrated Assessment Models (IAM) divide the world into a small number of highly aggregated regions. Non-OECD countries are aggregated geographically into continental and multiple-continental regions or economically by development level. Current research suggests that these large scale aggregations cannot accurately represent potential water resources-related climate change impacts. In addition, IAMs do not explicitly model the flow regulation impacts of reservoir and ground water systems, the economics of water supply, or the demand for water in economic activities. Using the International Model for Policy Analysis of Agricultural Commodities and Trade (IMPACT) model of the International Food Policy Research Institute (IFPRI) as a case study, this research implemented a set of methodologies to provide accurate representation of water resource climate change impacts in Integrated Assessment Models. There were also detailed examinations of key issues related to aggregated modeling including: modeling water consumption versus water withdrawals; ground and surface water interactions; development of reservoir cost curves; modeling of surface areas of aggregated reservoirs for estimating evaporation losses; and evaluating the importance of spatial scale in river basin modeling. The major findings include: - Continental or national or even large scale river basin aggregation of water supplies and demands do not accurately capture the impacts of climate change in the water and agricultural sector in IAMs. - Fortunately, there now exist gridden approaches (0.5 X 0.5 degrees) to model streamflows in a global analysis. The gridded approach to hydrologic modeling allows flexibility in aligning basin boundaries with national boundaries. This combined with GIS tools, high speed computers, and the growing availability of socio-economic gridded data bases allows assignment of

  20. Representing where along with what information in a model of a cortical patch.

    Directory of Open Access Journals (Sweden)

    Yasser Roudi

    2008-03-01

    Full Text Available Behaving in the real world requires flexibly combining and maintaining information about both continuous and discrete variables. In the visual domain, several lines of evidence show that neurons in some cortical networks can simultaneously represent information about the position and identity of objects, and maintain this combined representation when the object is no longer present. The underlying network mechanism for this combined representation is, however, unknown. In this paper, we approach this issue through a theoretical analysis of recurrent networks. We present a model of a cortical network that can retrieve information about the identity of objects from incomplete transient cues, while simultaneously representing their spatial position. Our results show that two factors are important in making this possible: A a metric organisation of the recurrent connections, and B a spatially localised change in the linear gain of neurons. Metric connectivity enables a localised retrieval of information about object identity, while gain modulation ensures localisation in the correct position. Importantly, we find that the amount of information that the network can retrieve and retain about identity is strongly affected by the amount of information it maintains about position. This balance can be controlled by global signals that change the neuronal gain. These results show that anatomical and physiological properties, which have long been known to characterise cortical networks, naturally endow them with the ability to maintain a conjunctive representation of the identity and location of objects.

  1. Fault detection in processes represented by PLS models using an EWMA control scheme

    KAUST Repository

    Harrou, Fouzi

    2016-10-20

    Fault detection is important for effective and safe process operation. Partial least squares (PLS) has been used successfully in fault detection for multivariate processes with highly correlated variables. However, the conventional PLS-based detection metrics, such as the Hotelling\\'s T and the Q statistics are not well suited to detect small faults because they only use information about the process in the most recent observation. Exponentially weighed moving average (EWMA), however, has been shown to be more sensitive to small shifts in the mean of process variables. In this paper, a PLS-based EWMA fault detection method is proposed for monitoring processes represented by PLS models. The performance of the proposed method is compared with that of the traditional PLS-based fault detection method through a simulated example involving various fault scenarios that could be encountered in real processes. The simulation results clearly show the effectiveness of the proposed method over the conventional PLS method.

  2. The Human Glioblastoma Cell Culture Resource: Validated Cell Models Representing All Molecular Subtypes

    Directory of Open Access Journals (Sweden)

    Yuan Xie

    2015-10-01

    Full Text Available Glioblastoma (GBM is the most frequent and malignant form of primary brain tumor. GBM is essentially incurable and its resistance to therapy is attributed to a subpopulation of cells called glioma stem cells (GSCs. To meet the present shortage of relevant GBM cell (GC lines we developed a library of annotated and validated cell lines derived from surgical samples of GBM patients, maintained under conditions to preserve GSC characteristics. This collection, which we call the Human Glioblastoma Cell Culture (HGCC resource, consists of a biobank of 48 GC lines and an associated database containing high-resolution molecular data. We demonstrate that the HGCC lines are tumorigenic, harbor genomic lesions characteristic of GBMs, and represent all four transcriptional subtypes. The HGCC panel provides an open resource for in vitro and in vivo modeling of a large part of GBM diversity useful to both basic and translational GBM research.

  3. An equivalent body surface charge model representing three-dimensional bioelectrical activity

    Science.gov (United States)

    He, B.; Chernyak, Y. B.; Cohen, R. J.

    1995-01-01

    A new surface-source model has been developed to account for the bioelectrical potential on the body surface. A single-layer surface-charge model on the body surface has been developed to equivalently represent bioelectrical sources inside the body. The boundary conditions on the body surface are discussed in relation to the surface-charge in a half-space conductive medium. The equivalent body surface-charge is shown to be proportional to the normal component of the electric field on the body surface just outside the body. The spatial resolution of the equivalent surface-charge distribution appears intermediate between those of the body surface potential distribution and the body surface Laplacian distribution. An analytic relationship between the equivalent surface-charge and the surface Laplacian of the potential was found for a half-space conductive medium. The effects of finite spatial sampling and noise on the reconstruction of the equivalent surface-charge were evaluated by computer simulations. It was found through computer simulations that the reconstruction of the equivalent body surface-charge from the body surface Laplacian distribution is very stable against noise and finite spatial sampling. The present results suggest that the equivalent body surface-charge model may provide an additional insight to our understanding of bioelectric phenomena.

  4. A class representative model for Pure Parsimony Haplotyping under uncertain data.

    Directory of Open Access Journals (Sweden)

    Daniele Catanzaro

    Full Text Available The Pure Parsimony Haplotyping (PPH problem is a NP-hard combinatorial optimization problem that consists of finding the minimum number of haplotypes necessary to explain a given set of genotypes. PPH has attracted more and more attention in recent years due to its importance in analysis of many fine-scale genetic data. Its application fields range from mapping complex disease genes to inferring population histories, passing through designing drugs, functional genomics and pharmacogenetics. In this article we investigate, for the first time, a recent version of PPH called the Pure Parsimony Haplotype problem under Uncertain Data (PPH-UD. This version mainly arises when the input genotypes are not accurate, i.e., when some single nucleotide polymorphisms are missing or affected by errors. We propose an exact approach to solution of PPH-UD based on an extended version of Catanzaro et al.[1] class representative model for PPH, currently the state-of-the-art integer programming model for PPH. The model is efficient, accurate, compact, polynomial-sized, easy to implement, solvable with any solver for mixed integer programming, and usable in all those cases for which the parsimony criterion is well suited for haplotype estimation.

  5. Representing grounding line migration in synchronous coupling between a marine ice sheet model and a z-coordinate ocean model

    Science.gov (United States)

    Goldberg, D. N.; Snow, K.; Holland, P.; Jordan, J. R.; Campin, J.-M.; Heimbach, P.; Arthern, R.; Jenkins, A.

    2018-05-01

    Synchronous coupling is developed between an ice sheet model and a z-coordinate ocean model (the MITgcm). A previously-developed scheme to allow continuous vertical movement of the ice-ocean interface of a floating ice shelf ("vertical coupling") is built upon to allow continuous movement of the grounding line, or point of floatation of the ice sheet ("horizontal coupling"). Horizontal coupling is implemented through the maintenance of a thin layer of ocean ( ∼ 1 m) under grounded ice, which is inflated into the real ocean as the ice ungrounds. This is accomplished through a modification of the ocean model's nonlinear free surface evolution in a manner akin to a hydrological model in the presence of steep bathymetry. The coupled model is applied to a number of idealized geometries and shown to successfully represent ocean-forced marine ice sheet retreat while maintaining a continuous ocean circulation.

  6. Diurnal Transcriptome and Gene Network Represented through Sparse Modeling in Brachypodium distachyon

    Directory of Open Access Journals (Sweden)

    Satoru Koda

    2017-11-01

    Full Text Available We report the comprehensive identification of periodic genes and their network inference, based on a gene co-expression analysis and an Auto-Regressive eXogenous (ARX model with a group smoothly clipped absolute deviation (SCAD method using a time-series transcriptome dataset in a model grass, Brachypodium distachyon. To reveal the diurnal changes in the transcriptome in B. distachyon, we performed RNA-seq analysis of its leaves sampled through a diurnal cycle of over 48 h at 4 h intervals using three biological replications, and identified 3,621 periodic genes through our wavelet analysis. The expression data are feasible to infer network sparsity based on ARX models. We found that genes involved in biological processes such as transcriptional regulation, protein degradation, and post-transcriptional modification and photosynthesis are significantly enriched in the periodic genes, suggesting that these processes might be regulated by circadian rhythm in B. distachyon. On the basis of the time-series expression patterns of the periodic genes, we constructed a chronological gene co-expression network and identified putative transcription factors encoding genes that might be involved in the time-specific regulatory transcriptional network. Moreover, we inferred a transcriptional network composed of the periodic genes in B. distachyon, aiming to identify genes associated with other genes through variable selection by grouping time points for each gene. Based on the ARX model with the group SCAD regularization using our time-series expression datasets of the periodic genes, we constructed gene networks and found that the networks represent typical scale-free structure. Our findings demonstrate that the diurnal changes in the transcriptome in B. distachyon leaves have a sparse network structure, demonstrating the spatiotemporal gene regulatory network over the cyclic phase transitions in B. distachyon diurnal growth.

  7. Modeling Optimal Cutoffs for the Brazilian Household Food Insecurity Measurement Scale in a Nationwide Representative Sample.

    Science.gov (United States)

    Interlenghi, Gabriela S; Reichenheim, Michael E; Segall-Corrêa, Ana M; Pérez-Escamilla, Rafael; Moraes, Claudia L; Salles-Costa, Rosana

    2017-07-01

    Background: This is the second part of a model-based approach to examine the suitability of the current cutoffs applied to the raw score of the Brazilian Household Food Insecurity Measurement Scale [Escala Brasileira de Insegurança Alimentar (EBIA)]. The approach allows identification of homogeneous groups who correspond to severity levels of food insecurity (FI) and, by extension, discriminant cutoffs able to accurately distinguish these groups. Objective: This study aims to examine whether the model-based approach for identifying optimal cutoffs first implemented in a local sample is replicated in a countrywide representative sample. Methods: Data were derived from the Brazilian National Household Sample Survey of 2013 ( n = 116,543 households). Latent class factor analysis (LCFA) models from 2 to 5 classes were applied to the scale's items to identify the number of underlying FI latent classes. Next, identification of optimal cutoffs on the overall raw score was ascertained from these identified classes. Analyses were conducted in the aggregate data and by macroregions. Finally, model-based classifications (latent classes and groupings identified thereafter) were contrasted to the traditionally used classification. Results: LCFA identified 4 homogeneous groups with a very high degree of class separation (entropy = 0.934-0.975). The following cutoffs were identified in the aggregate data: between 1 and 2 (1/2), 5 and 6 (5/6), and 10 and 11 (10/11) in households with children and/or adolescents category emerged consistently in all analyses. Conclusions: Nationwide findings corroborate previous local evidence that households with an overall score of 1 are more akin to those scoring negative on all items. These results may contribute to guide experts' and policymakers' decisions on the most appropriate EBIA cutoffs. © 2017 American Society for Nutrition.

  8. GGRaSP: A R-package for selecting representative genomes using Gaussian mixture models.

    Science.gov (United States)

    Clarke, Thomas H; Brinkac, Lauren M; Sutton, Granger; Fouts, Derrick E

    2018-04-14

    The vast number of available sequenced bacterial genomes occasionally exceeds the facilities of comparative genomic methods or is dominated by a single outbreak strain, and thus a diverse and representative subset is required. Generation of the reduced subset currently requires a priori supervised clustering and sequence-only selection of medoid genomic sequences, independent of any additional genome metrics or strain attributes. The GGRaSP R-package described below generates a reduced subset of genomes that prioritizes maintaining genomes of interest to the user as well as minimizing the loss of genetic variation. The package also allows for unsupervised clustering by modeling the genomic relationships using a Gaussian Mixture Model to select an appropriate cluster threshold. We demonstrate the capabilities of GGRaSP by generating a reduced list of 315 genomes from a genomic dataset of 4600 Escherichia coli genomes, prioritizing selection by type strain and by genome completeness. GGRaSP is available at https://github.com/JCVenterInstitute/ggrasp/. tclarke@jcvi.org. Supplementary data are available at the GitHub site.

  9. Clinical isolates of Yersinia enterocolitica Biotype 1A represent two phylogenetic lineages with differing pathogenicity-related properties

    Directory of Open Access Journals (Sweden)

    Sihvonen Leila M

    2012-09-01

    Full Text Available Abstract Background Y. enterocolitica biotype (BT 1A strains are often isolated from human clinical samples but their contribution to disease has remained a controversial topic. Variation and the population structure among the clinical Y. enterocolitica BT 1A isolates have been poorly characterized. We used multi-locus sequence typing (MLST, 16S rRNA gene sequencing, PCR for ystA and ystB, lipopolysaccharide analysis, phage typing, human serum complement killing assay and analysis of the symptoms of the patients to characterize 298 clinical Y. enterocolitica BT 1A isolates in order to evaluate their relatedness and pathogenic potential. Results A subset of 71 BT 1A strains, selected based on their varying LPS patterns, were subjected to detailed genetic analyses. The MLST on seven house-keeping genes (adk, argA, aroA, glnA, gyrB, thrA, trpE conducted on 43 of the strains discriminated them into 39 MLST-types. By Bayesian analysis of the population structure (BAPS the strains clustered conclusively into two distinct lineages, i.e. Genetic groups 1 and 2. The strains of Genetic group 1 were more closely related (97% similarity to the pathogenic bio/serotype 4/O:3 strains than Genetic group 2 strains (95% similarity. Further comparison of the 16S rRNA genes of the BT 1A strains indicated that altogether 17 of the 71 strains belong to Genetic group 2. On the 16S rRNA analysis, these 17 strains were only 98% similar to the previously identified subspecies of Y. enterocolitica. The strains of Genetic group 2 were uniform in their pathogenecity-related properties: they lacked the ystB gene, belonged to the same LPS subtype or were of rough type, were all resistant to the five tested yersiniophages, were largely resistant to serum complement and did not ferment fucose. The 54 strains in Genetic group 1 showed much more variation in these properties. The most commonly detected LPS types were similar to the LPS types of reference strains with serotypes O

  10. Representing Farmer Irrigation Decisions in Northern India: Model Development from the Bottom Up.

    Science.gov (United States)

    O'Keeffe, J.; Buytaert, W.; Brozovic, N.; Mijic, A.

    2017-12-01

    The plains of northern India are among the most intensely populated and irrigated regions of the world. Sustaining water demand has been made possible by exploiting the vast and hugely productive aquifers underlying the Indo-Gangetic basin. However, an increasing demand from a growing population and highly variable socio-economic and environmental variables mean present resources may not be sustainable, resulting in water security becoming one of India's biggest challenges. Unless solutions which take into consideration the regions evolving anthropogenic and environmental conditions are found, the sustainability of India's water resources looks bleak. Understanding water user decisions and their potential outcome is important for development of suitable water resource management options. Computational models are commonly used to assist water use decision making, typically representing natural processes well. The inclusion of human decision making however, one of the dominant drivers of change, has lagged behind. Improved representation of irrigation water user behaviour within models provides more accurate, relevant information for irrigation management. This research conceptualizes and proceduralizes observed farmer irrigation practices, highlighting feedbacks between the environment and livelihood. It is developed using a bottom up approach, informed through field experience and stakeholder interaction in Uttar Pradesh, northern India. Real world insights are incorporated through collected information creating a realistic representation of field conditions, providing a useful tool for policy analysis and water management. The modelling framework is applied to four districts. Results suggest predicted future climate will have little direct impact on water resources, crop yields or farmer income. In addition, increased abstraction may be sustainable in some areas under carefully managed conditions. By simulating dynamic decision making, feedbacks and interactions

  11. 8760-Based Method for Representing Variable Generation Capacity Value in Capacity Expansion Models: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Frew, Bethany A [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Cole, Wesley J [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Sun, Yinong [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Mai, Trieu T [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Richards, James [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2017-08-01

    Capacity expansion models (CEMs) are widely used to evaluate the least-cost portfolio of electricity generators, transmission, and storage needed to reliably serve demand over the evolution of many years or decades. Various CEM formulations are used to evaluate systems ranging in scale from states or utility service territories to national or multi-national systems. CEMs can be computationally complex, and to achieve acceptable solve times, key parameters are often estimated using simplified methods. In this paper, we focus on two of these key parameters associated with the integration of variable generation (VG) resources: capacity value and curtailment. We first discuss common modeling simplifications used in CEMs to estimate capacity value and curtailment, many of which are based on a representative subset of hours that can miss important tail events or which require assumptions about the load and resource distributions that may not match actual distributions. We then present an alternate approach that captures key elements of chronological operation over all hours of the year without the computationally intensive economic dispatch optimization typically employed within more detailed operational models. The updated methodology characterizes the (1) contribution of VG to system capacity during high load and net load hours, (2) the curtailment level of VG, and (3) the potential reductions in curtailments enabled through deployment of storage and more flexible operation of select thermal generators. We apply this alternate methodology to an existing CEM, the Regional Energy Deployment System (ReEDS). Results demonstrate that this alternate approach provides more accurate estimates of capacity value and curtailments by explicitly capturing system interactions across all hours of the year. This approach could be applied more broadly to CEMs at many different scales where hourly resource and load data is available, greatly improving the representation of challenges

  12. Voxel-based models representing the male and female ICRP reference adult - the skeleton

    International Nuclear Information System (INIS)

    Zankl, M.; Eckerman, K.F.; Bolch, W.E.

    2007-01-01

    For the forthcoming update of organ dose conversion coefficients, the International Commission on Radiological Protection (ICRP) will use voxel-based computational phantoms due to their improved anatomical realism compared with the class of mathematical or stylized phantoms used previously. According to the ICRP philosophy, these phantoms should be representative of the male and female reference adults with respect to their external dimensions, their organ topology and their organ masses. To meet these requirements, reference models of an adult male and adult female have been constructed at the GSF, based on existing voxel models segmented from tomographic images of two individuals whose body height and weight closely resemble the ICRP Publication 89 reference values. The skeleton is a highly complex structure of the body, composed of cortical bone, trabecular bone, red and yellow bone marrow and endosteum ('bone surfaces' in their older terminology). The skeleton of the reference phantoms consists of 19 individually segmented bones and bone groups. Sub-division of these bones into the above-mentioned constituents would be necessary in order to allow a direct calculation of dose to red bone marrow and endosteum. However, the dimensions of the trabeculae, the cavities containing bone marrow and the endosteum layer lining these cavities are clearly smaller than the resolution of a normal CT scan and, thus, these volumes could not be segmented in the tomographic images. As an attempt to represent the gross spatial distribution of these regions as realistically as possible at the given voxel resolution, 48 individual organ identification numbers were assigned to various parts of the skeleton: every segmented bone was subdivided into an outer shell of cortical bone and a spongious core; in the shafts of the long bones, a medullary cavity was additionally segmented. Using the data from ICRP Publication 89 on elemental tissue composition, from ICRU Report 46 on material

  13. Representing dispositions

    Directory of Open Access Journals (Sweden)

    Röhl Johannes

    2011-08-01

    Full Text Available Abstract Dispositions and tendencies feature significantly in the biomedical domain and therefore in representations of knowledge of that domain. They are not only important for specific applications like an infectious disease ontology, but also as part of a general strategy for modelling knowledge about molecular interactions. But the task of representing dispositions in some formal ontological systems is fraught with several problems, which are partly due to the fact that Description Logics can only deal well with binary relations. The paper will discuss some of the results of the philosophical debate about dispositions, in order to see whether the formal relations needed to represent dispositions can be broken down to binary relations. Finally, we will discuss problems arising from the possibility of the absence of realizations, of multi-track or multi-trigger dispositions and offer suggestions on how to deal with them.

  14. Evaluating Weather Research and Forecasting Model Sensitivity to Land and Soil Conditions Representative of Karst Landscapes

    Science.gov (United States)

    Johnson, Christopher M.; Fan, Xingang; Mahmood, Rezaul; Groves, Chris; Polk, Jason S.; Yan, Jun

    2018-03-01

    Due to their particular physiographic, geomorphic, soil cover, and complex surface-subsurface hydrologic conditions, karst regions produce distinct land-atmosphere interactions. It has been found that floods and droughts over karst regions can be more pronounced than those in non-karst regions following a given rainfall event. Five convective weather events are simulated using the Weather Research and Forecasting model to explore the potential impacts of land-surface conditions on weather simulations over karst regions. Since no existing weather or climate model has the ability to represent karst landscapes, simulation experiments in this exploratory study consist of a control (default land-cover/soil types) and three land-surface conditions, including barren ground, forest, and sandy soils over the karst areas, which mimic certain karst characteristics. Results from sensitivity experiments are compared with the control simulation, as well as with the National Centers for Environmental Prediction multi-sensor precipitation analysis Stage-IV data, and near-surface atmospheric observations. Mesoscale features of surface energy partition, surface water and energy exchange, the resulting surface-air temperature and humidity, and low-level instability and convective energy are analyzed to investigate the potential land-surface impact on weather over karst regions. We conclude that: (1) barren ground used over karst regions has a pronounced effect on the overall simulation of precipitation. Barren ground provides the overall lowest root-mean-square errors and bias scores in precipitation over the peak-rain periods. Contingency table-based equitable threat and frequency bias scores suggest that the barren and forest experiments are more successful in simulating light to moderate rainfall. Variables dependent on local surface conditions show stronger contrasts between karst and non-karst regions than variables dominated by large-scale synoptic systems; (2) significant

  15. Wound care clinical pathway: a conceptual model.

    Science.gov (United States)

    Barr, J E; Cuzzell, J

    1996-08-01

    A clinical pathway is a written sequence of clinical processes or events that guides a patient with a defined problem toward an expected outcome. Clinical pathways are tools to assist with the cost-effective management of clinical outcomes related to specific problems or disease processes. The primary obstacles to developing clinical pathways for wound care are the chronic natures of some wounds and the many variables that can delay healing. The pathway introduced in this article was modeled upon the three phases of tissue repair: inflammatory, proliferative, and maturation. This physiology-based model allows clinicians to identify and monitor outcomes based on observable and measurable clinical parameters. The pathway design, which also includes educational and behavioral outcomes, allows the clinician to individualize the expected timeframe for outcome achievement based on individual patient criteria and expert judgement. Integral to the pathway are the "4P's" which help standardize the clinical processes by wound type: Protocols, Policies, Procedures, and Patient education tools. Four categories into which variances are categorized based on the cause of the deviation from the norm are patient, process/system, practitioner, and planning/discharge. Additional research is warranted to support the value of this clinical pathway in the clinical arena.

  16. Regulatory T cell frequency, but not plasma IL-33 levels, represents potential immunological biomarker to predict clinical response to intravenous immunoglobulin therapy.

    Science.gov (United States)

    Maddur, Mohan S; Stephen-Victor, Emmanuel; Das, Mrinmoy; Prakhar, Praveen; Sharma, Varun K; Singh, Vikas; Rabin, Magalie; Trinath, Jamma; Balaji, Kithiganahalli N; Bolgert, Francis; Vallat, Jean-Michel; Magy, Laurent; Kaveri, Srini V; Bayry, Jagadeesh

    2017-03-20

    Intravenous immunoglobulin (IVIG) is a polyspecific pooled immunoglobulin G preparation and one of the commonly used therapeutics for autoimmune diseases including those of neurological origin. A recent report in murine model proposed that IVIG expands regulatory T (T reg ) cells via induction of interleukin 33 (IL-33). However, translational insight on these observations is lacking. Ten newly diagnosed Guillain-Barré syndrome (GBS) patients were treated with IVIG at the rate of 0.4 g/kg for three to five consecutive days. Clinical evaluation for muscular weakness was performed by Medical Research Council (MRC) and modified Rankin scoring (MRS) system. Heparinized blood samples were collected before and 1, 2, and 4-5 weeks post-IVIG therapy. Peripheral blood mononuclear cells were stained for surface CD4 and intracellular Foxp3, IFN-γ, and tumor necrosis factor alpha (TNF-α) and were analyzed by flow cytometry. IL-33 and prostaglandin E2 in the plasma were measured by ELISA. The fold changes in plasma IL-33 at week 1 showed no correlation with the MRC and MRS scores at weeks 1, 2, and ≥4 post-IVIG therapy. Clinical recovery following IVIG therapy appears to be associated with T reg cell response. Contrary to murine study, there was no association between the fold changes in IL-33 at week 1 and T reg cell frequency at weeks 1, 2, and ≥4 post-IVIG therapy. T reg cell-mediated clinical response to IVIG therapy in GBS patients was associated with reciprocal regulation of effector T cells-expressing TNF-α. T reg cell expansion by IVIG in patients with autoimmune diseases lack correlation with IL-33. T reg cell frequency, but not plasma IL-33 levels, represents potential immunological biomarker to predict clinical response to IVIG therapy.

  17. Evaluation of clinical information modeling tools.

    Science.gov (United States)

    Moreno-Conde, Alberto; Austin, Tony; Moreno-Conde, Jesús; Parra-Calderón, Carlos L; Kalra, Dipak

    2016-11-01

    Clinical information models are formal specifications for representing the structure and semantics of the clinical content within electronic health record systems. This research aims to define, test, and validate evaluation metrics for software tools designed to support the processes associated with the definition, management, and implementation of these models. The proposed framework builds on previous research that focused on obtaining agreement on the essential requirements in this area. A set of 50 conformance criteria were defined based on the 20 functional requirements agreed by that consensus and applied to evaluate the currently available tools. Of the 11 initiative developing tools for clinical information modeling identified, 9 were evaluated according to their performance on the evaluation metrics. Results show that functionalities related to management of data types, specifications, metadata, and terminology or ontology bindings have a good level of adoption. Improvements can be made in other areas focused on information modeling and associated processes. Other criteria related to displaying semantic relationships between concepts and communication with terminology servers had low levels of adoption. The proposed evaluation metrics were successfully tested and validated against a representative sample of existing tools. The results identify the need to improve tool support for information modeling and software development processes, especially in those areas related to governance, clinician involvement, and optimizing the technical validation of testing processes. This research confirmed the potential of these evaluation metrics to support decision makers in identifying the most appropriate tool for their organization. Los Modelos de Información Clínica son especificaciones para representar la estructura y características semánticas del contenido clínico en los sistemas de Historia Clínica Electrónica. Esta investigación define, prueba y valida

  18. Representing and estimating interactions between activities in a need-based model of activity generation

    NARCIS (Netherlands)

    Nijland, L.; Arentze, T.; Timmermans, H.

    2013-01-01

    Although several activity-based models made the transition to practice in recent years, modeling dynamic activity generation and especially, the mechanisms underlying activity generation are not well incorporated in the current activity-based models. For instance, current models assume that

  19. Representing and estimating interactions between activities in a need-based model of activity generation

    NARCIS (Netherlands)

    Nijland, E.W.L.; Arentze, T.A.; Timmermans, H.J.P.

    2011-01-01

    Although several activity-based models made the transition to practice in recent years, modelling dynamic activity generation and especially, the mechanisms underlying activity generation are not well incorporated in the current activity-based models. For example, current models assume that

  20. Semantic Modeling for Exposomics with Exploratory Evaluation in Clinical Context

    Directory of Open Access Journals (Sweden)

    Jung-wei Fan

    2017-01-01

    Full Text Available Exposome is a critical dimension in the precision medicine paradigm. Effective representation of exposomics knowledge is instrumental to melding nongenetic factors into data analytics for clinical research. There is still limited work in (1 modeling exposome entities and relations with proper integration to mainstream ontologies and (2 systematically studying their presence in clinical context. Through selected ontological relations, we developed a template-driven approach to identifying exposome concepts from the Unified Medical Language System (UMLS. The derived concepts were evaluated in terms of literature coverage and the ability to assist in annotating clinical text. The generated semantic model represents rich domain knowledge about exposure events (454 pairs of relations between exposure and outcome. Additionally, a list of 5667 disorder concepts with microbial etiology was created for inferred pathogen exposures. The model consistently covered about 90% of PubMed literature on exposure-induced iatrogenic diseases over 10 years (2001–2010. The model contributed to the efficiency of exposome annotation in clinical text by filtering out 78% of irrelevant machine annotations. Analysis into 50 annotated discharge summaries helped advance our understanding of the exposome information in clinical text. This pilot study demonstrated feasibility of semiautomatically developing a useful semantic resource for exposomics.

  1. Representing of Information Attacks in the Conditions of a Reference Model OSE/RM

    Directory of Open Access Journals (Sweden)

    Vladimir Sergeevich Kuznetsov

    2013-02-01

    Full Text Available Graphic representation of attacks to open systems within the conceptual OSE/RM model is considered in the paper. Attacks are classified according to level of their action in the 7th level OSI model.

  2. Selecting representative climate models for climate change impact studies : An advanced envelope-based selection approach

    NARCIS (Netherlands)

    Lutz, Arthur F.; ter Maat, Herbert W.; Biemans, Hester; Shrestha, Arun B.; Wester, Philippus; Immerzeel, Walter W.|info:eu-repo/dai/nl/290472113

    2016-01-01

    Climate change impact studies depend on projections of future climate provided by climate models. The number of climate models is large and increasing, yet limitations in computational capacity make it necessary to compromise the number of climate models that can be included in a climate change

  3. Selecting representative climate models for climate change impact studies: an advanced envelope-based selection approach

    NARCIS (Netherlands)

    Lutz, Arthur F.; Maat, ter Herbert W.; Biemans, Hester; Shrestha, Arun B.; Wester, Philippus; Immerzeel, Walter W.

    2016-01-01

    Climate change impact studies depend on projections of future climate provided by climate models. The number of climate models is large and increasing, yet limitations in computational capacity make it necessary to compromise the number of climate models that can be included in a climate change

  4. Role modeling excellence in clinical nursing practice.

    Science.gov (United States)

    Perry, R N Beth

    2009-01-01

    Role modeling excellence in clinical nursing practice is the focus of this paper. The phenomenological research study reported involved a group of 8 nurses identified by their colleagues as exemplary. The major theme revealed in this study was that these exemplary nurses were also excellent role models in the clinical setting. This paper details approaches used by these nurses that made them excellent role models. Specifically, the themes of attending to the little things, making connections, maintaining a light-hearted attitude, modeling, and affirming others are presented. These themes are discussed within the framework of Watson [Watson, J., 1989. Human caring and suffering: a subjective model for health services. In: Watson, J., Taylor, R. (Eds.), They Shall Not Hurt: Human Suffering and Human Caring. Colorado University, Boulder, CO] "transpersonal caring" and [Bandura, A., 1997. Social Learning Theory. Prentice Hall, Englewood Cliffs, NJ] "Social Learning Theory." Particular emphasis in the discussion is on how positive role modeling by exemplary practitioners can contribute to the education of clinical nurses in the practice setting.

  5. Random effects models in clinical research

    NARCIS (Netherlands)

    Cleophas, T. J.; Zwinderman, A. H.

    2008-01-01

    BACKGROUND: In clinical trials a fixed effects research model assumes that the patients selected for a specific treatment have the same true quantitative effect and that the differences observed are residual error. If, however, we have reasons to believe that certain patients respond differently

  6. Representing the atmospheric boundary layer in climate models of intermediate compexity

    NARCIS (Netherlands)

    Ronda, R.J.; Haarsma, R.J.; Holtslag, A.A.M.

    2003-01-01

    In this study the role of atmospheric boundary layer schemes in climate models is investigated. Including a boundary layer scheme in an Earth system model of intermediate complexity (EMIC) produces only minor differences in the estimated global distribution of sensible and latent heat fluxes over

  7. The Demand Side in Economic Models of Energy Markets: The Challenge of Representing Consumer Behavior

    International Nuclear Information System (INIS)

    Krysiak, Frank C.; Weigt, Hannes

    2015-01-01

    Energy models play an increasing role in the ongoing energy transition processes either as tools for forecasting potential developments or for assessments of policy and market design options. In recent years, these models have increased in scope and scale and provide a reasonable representation of the energy supply side, technological aspects and general macroeconomic interactions. However, the representation of the demand side and consumer behavior has remained rather simplistic. The objective of this paper is twofold. First, we review existing large-scale energy model approaches, namely bottom-up and top-down models, with respect to their demand-side representation. Second, we identify gaps in existing approaches and draft potential pathways to account for a more detailed demand-side and behavior representation in energy modeling.

  8. The Demand Side in Economic Models of Energy Markets: The Challenge of Representing Consumer Behavior

    Energy Technology Data Exchange (ETDEWEB)

    Krysiak, Frank C., E-mail: frank.krysiak@unibas.ch; Weigt, Hannes [Department of Business and Economics, University of Basel, Basel (Switzerland)

    2015-05-19

    Energy models play an increasing role in the ongoing energy transition processes either as tools for forecasting potential developments or for assessments of policy and market design options. In recent years, these models have increased in scope and scale and provide a reasonable representation of the energy supply side, technological aspects and general macroeconomic interactions. However, the representation of the demand side and consumer behavior has remained rather simplistic. The objective of this paper is twofold. First, we review existing large-scale energy model approaches, namely bottom-up and top-down models, with respect to their demand-side representation. Second, we identify gaps in existing approaches and draft potential pathways to account for a more detailed demand-side and behavior representation in energy modeling.

  9. The Demand Side in Economic Models of Energy Markets: The Challenge of Representing Consumer Behavior

    Directory of Open Access Journals (Sweden)

    Frank eKrysiak

    2015-05-01

    Full Text Available Energy models play an increasing role in the ongoing energy transition processes either as tools for forecasting potential developments or for assessments of policy and market design options. In recent years these models have increased in scope and scale and provide a reasonable representation of the energy supply side, technological aspects and general macroeconomic interactions. However, the representation of the demand side and consumer behavior has remained rather simplistic. The objective of this paper is twofold. First, we review existing large scale energy model approaches, namely bottom-up and top-down models, with respect to their demand side representation. Second, we identify gaps in existing approaches and draft potential pathways to account for a more detailed demand side and behavior representation in energy modeling.

  10. Reproducing tailing in breakthrough curves: Are statistical models equally representative and predictive?

    Science.gov (United States)

    Pedretti, Daniele; Bianchi, Marco

    2018-03-01

    Breakthrough curves (BTCs) observed during tracer tests in highly heterogeneous aquifers display strong tailing. Power laws are popular models for both the empirical fitting of these curves, and the prediction of transport using upscaling models based on best-fitted estimated parameters (e.g. the power law slope or exponent). The predictive capacity of power law based upscaling models can be however questioned due to the difficulties to link model parameters with the aquifers' physical properties. This work analyzes two aspects that can limit the use of power laws as effective predictive tools: (a) the implication of statistical subsampling, which often renders power laws undistinguishable from other heavily tailed distributions, such as the logarithmic (LOG); (b) the difficulties to reconcile fitting parameters obtained from models with different formulations, such as the presence of a late-time cutoff in the power law model. Two rigorous and systematic stochastic analyses, one based on benchmark distributions and the other on BTCs obtained from transport simulations, are considered. It is found that a power law model without cutoff (PL) results in best-fitted exponents (αPL) falling in the range of typical experimental values reported in the literature (1.5 tailing becomes heavier. Strong fluctuations occur when the number of samples is limited, due to the effects of subsampling. On the other hand, when the power law model embeds a cutoff (PLCO), the best-fitted exponent (αCO) is insensitive to the degree of tailing and to the effects of subsampling and tends to a constant αCO ≈ 1. In the PLCO model, the cutoff rate (λ) is the parameter that fully reproduces the persistence of the tailing and is shown to be inversely correlated to the LOG scale parameter (i.e. with the skewness of the distribution). The theoretical results are consistent with the fitting analysis of a tracer test performed during the MADE-5 experiment. It is shown that a simple

  11. South Asians are Under-Represented in a Clinic Treating Atrial Fibrillation in a Multicultural City in the UK.

    Science.gov (United States)

    Tayebjee, M H; Tyndall, K; Holding, S; Russell, C; Graham, L N; Pepper, C B

    2012-01-01

    The Leeds rapid access atrial fibrillation (AF) clinic was set up to streamline and standardise management of patients with newly diagnosed AF. Anecdotal evidence suggests that there is under-representation of south Asians in these clinics.All patient attendances between June 2007 and June 2011 were documented and combined with ethnicity data from patient administration records. Local population demographics for 2009 were obtained from the office of national statistics. This was used to estimate the expected prevalence of AF across the different ethnic groups in Leeds taking age into account. One thousand two hundred and ten patients were referred. The study sample included 992 patients, and the number of south Asians attending was 88% less than expected (Chi squared analysis; pcosmopolitan population. Potential reasons for this discrepancy including barriers to accessing treatment for this population or a lower prevalence of AF in south Asians due to an as yet unidentified genetic factor.

  12. Representing general theoretical concepts in structural equation models: The role of composite variables

    Science.gov (United States)

    Grace, J.B.; Bollen, K.A.

    2008-01-01

    Structural equation modeling (SEM) holds the promise of providing natural scientists the capacity to evaluate complex multivariate hypotheses about ecological systems. Building on its predecessors, path analysis and factor analysis, SEM allows for the incorporation of both observed and unobserved (latent) variables into theoretically-based probabilistic models. In this paper we discuss the interface between theory and data in SEM and the use of an additional variable type, the composite. In simple terms, composite variables specify the influences of collections of other variables and can be helpful in modeling heterogeneous concepts of the sort commonly of interest to ecologists. While long recognized as a potentially important element of SEM, composite variables have received very limited use, in part because of a lack of theoretical consideration, but also because of difficulties that arise in parameter estimation when using conventional solution procedures. In this paper we present a framework for discussing composites and demonstrate how the use of partially-reduced-form models can help to overcome some of the parameter estimation and evaluation problems associated with models containing composites. Diagnostic procedures for evaluating the most appropriate and effective use of composites are illustrated with an example from the ecological literature. It is argued that an ability to incorporate composite variables into structural equation models may be particularly valuable in the study of natural systems, where concepts are frequently multifaceted and the influence of suites of variables are often of interest. ?? Springer Science+Business Media, LLC 2007.

  13. Investigation of representing hysteresis in macroscopic models of two-phase flow in porous media using intermediate scale experimental data

    Science.gov (United States)

    Cihan, Abdullah; Birkholzer, Jens; Trevisan, Luca; Gonzalez-Nicolas, Ana; Illangasekare, Tissa

    2017-01-01

    Incorporating hysteresis into models is important to accurately capture the two phase flow behavior when porous media systems undergo cycles of drainage and imbibition such as in the cases of injection and post-injection redistribution of CO2 during geological CO2 storage (GCS). In the traditional model of two-phase flow, existing constitutive models that parameterize the hysteresis associated with these processes are generally based on the empirical relationships. This manuscript presents development and testing of mathematical hysteretic capillary pressure—saturation—relative permeability models with the objective of more accurately representing the redistribution of the fluids after injection. The constitutive models are developed by relating macroscopic variables to basic physics of two-phase capillary displacements at pore-scale and void space distribution properties. The modeling approach with the developed constitutive models with and without hysteresis as input is tested against some intermediate-scale flow cell experiments to test the ability of the models to represent movement and capillary trapping of immiscible fluids under macroscopically homogeneous and heterogeneous conditions. The hysteretic two-phase flow model predicted the overall plume migration and distribution during and post injection reasonably well and represented the postinjection behavior of the plume more accurately than the nonhysteretic models. Based on the results in this study, neglecting hysteresis in the constitutive models of the traditional two-phase flow theory can seriously overpredict or underpredict the injected fluid distribution during post-injection under both homogeneous and heterogeneous conditions, depending on the selected value of the residual saturation in the nonhysteretic models.

  14. Student perception and conceptual development as represented by student mental models of atomic structure

    Science.gov (United States)

    Park, Eun Jung

    The nature of matter based upon atomic theory is a principal concept in science; hence, how to teach and how to learn about atoms is an important subject for science education. To this end, this study explored student perceptions of atomic structure and how students learn about this concept by analyzing student mental models of atomic structure. Changes in student mental models serve as a valuable resource for comprehending student conceptual development. Data was collected from students who were taking the introductory chemistry course. Responses to course examinations, pre- and post-questionnaires, and pre- and post-interviews were used to analyze student mental models of atomic structure. First, this study reveals that conceptual development can be achieved, either by elevating mental models toward higher levels of understanding or by developing a single mental model. This study reinforces the importance of higher-order thinking skills to enable students to relate concepts in order to construct a target model of atomic structure. Second, Bohr's orbital structure seems to have had a strong influence on student perceptions of atomic structure. With regard to this finding, this study suggests that it is instructionally important to teach the concept of "orbitals" related to "quantum theory." Third, there were relatively few students who had developed understanding at the level of the target model, which required student understanding of the basic ideas of quantum theory. This study suggests that the understanding of atomic structure based on the idea of quantum theory is both important and difficult. Fourth, this study included different student assessments comprised of course examinations, questionnaires, and interviews. Each assessment can be used to gather information to map out student mental models. Fifth, in the comparison of the pre- and post-interview responses, this study showed that high achieving students moved toward more improved models or to advanced

  15. Triangular model integrating clinical teaching and assessment.

    Science.gov (United States)

    Abdelaziz, Adel; Koshak, Emad

    2014-01-01

    Structuring clinical teaching is a challenge facing medical education curriculum designers. A variety of instructional methods on different domains of learning are indicated to accommodate different learning styles. Conventional methods of clinical teaching, like training in ambulatory care settings, are prone to the factor of coincidence in having varieties of patient presentations. Accordingly, alternative methods of instruction are indicated to compensate for the deficiencies of these conventional methods. This paper presents an initiative that can be used to design a checklist as a blueprint to guide appropriate selection and implementation of teaching/learning and assessment methods in each of the educational courses and modules based on educational objectives. Three categories of instructional methods were identified, and within each a variety of methods were included. These categories are classroom-type settings, health services-based settings, and community service-based settings. Such categories have framed our triangular model of clinical teaching and assessment.

  16. Modelling and Decision Support of Clinical Pathways

    Science.gov (United States)

    Gabriel, Roland; Lux, Thomas

    The German health care market is under a rapid rate of change, forcing especially hospitals to provide high-quality services at low costs. Appropriate measures for more effective and efficient service provision are process orientation and decision support by information technology of clinical pathway of a patient. The essential requirements are adequate modelling of clinical pathways as well as usage of adequate systems, which are capable of assisting the complete path of a patient within a hospital, and preferably also outside of it, in a digital way. To fulfil these specifications the authors present a suitable concept, which meets the challenges of well-structured clinical pathways as well as rather poorly structured diagnostic and therapeutic decisions, by interplay of process-oriented and knowledge-based hospital information systems.

  17. 8760-Based Method for Representing Variable Generation Capacity Value in Capacity Expansion Models

    Energy Technology Data Exchange (ETDEWEB)

    Frew, Bethany A [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2017-08-03

    Capacity expansion models (CEMs) are widely used to evaluate the least-cost portfolio of electricity generators, transmission, and storage needed to reliably serve load over many years or decades. CEMs can be computationally complex and are often forced to estimate key parameters using simplified methods to achieve acceptable solve times or for other reasons. In this paper, we discuss one of these parameters -- capacity value (CV). We first provide a high-level motivation for and overview of CV. We next describe existing modeling simplifications and an alternate approach for estimating CV that utilizes hourly '8760' data of load and VG resources. We then apply this 8760 method to an established CEM, the National Renewable Energy Laboratory's (NREL's) Regional Energy Deployment System (ReEDS) model (Eurek et al. 2016). While this alternative approach for CV is not itself novel, it contributes to the broader CEM community by (1) demonstrating how a simplified 8760 hourly method, which can be easily implemented in other power sector models when data is available, more accurately captures CV trends than a statistical method within the ReEDS CEM, and (2) providing a flexible modeling framework from which other 8760-based system elements (e.g., demand response, storage, and transmission) can be added to further capture important dynamic interactions, such as curtailment.

  18. Representing Northern Peatland Hydrology and Biogeochemistry with ALM Land Surface Model

    Science.gov (United States)

    Shi, X.; Ricciuto, D. M.; Thornton, P. E.; Hanson, P. J.; Xu, X.; Mao, J.; Warren, J.; Yuan, F.; Norby, R. J.; Sebestyen, S.; Griffiths, N.; Weston, D. J.; Walker, A.

    2017-12-01

    Northern peatlands are likely to be important in future carbon cycle-climate feedbacks due to their large carbon pool and vulnerability to hydrological change. Predictive understanding of northern peatland hydrology is a necessary precursor to understanding the fate of massive carbon stores in these systems under the influence of present and future climate change. Current models have begun to address microtopographic controls on peatland hydrology, but none have included a prognostic calculation of peatland water table depth for a vegetated wetland, independent of prescribed regional water tables. Firstly, we introduce a new configuration of the land model (ALM) of Accelerated Climate model for Energy (ACME), which includes a fully prognostic water table calculation for a vegetated peatland. Secondly, we couple our new hydrology treatment with vertically structured soil organic matter pool, and the addition of components from methane biogeochemistry. Thirdly, we introduce a new PFT for mosses and implement the water content dynamics and physiology of mosses. We inform and test our model based on SPRUCE experiment to get the reasonable results for the seasonal dynamics water table depths, water content dynamics and physiology of mosses, and correct soil carbon profiles. Then, we use our new model structure to test the how the water table depth and CH4 emission will respond to elevated CO2 and different warming scenarios.

  19. Large-scale Modeling of Nitrous Oxide Production: Issues of Representing Spatial Heterogeneity

    Science.gov (United States)

    Morris, C. K.; Knighton, J.

    2017-12-01

    Nitrous oxide is produced from the biological processes of nitrification and denitrification in terrestrial environments and contributes to the greenhouse effect that warms Earth's climate. Large scale modeling can be used to determine how global rate of nitrous oxide production and consumption will shift under future climates. However, accurate modeling of nitrification and denitrification is made difficult by highly parameterized, nonlinear equations. Here we show that the representation of spatial heterogeneity in inputs, specifically soil moisture, causes inaccuracies in estimating the average nitrous oxide production in soils. We demonstrate that when soil moisture is averaged from a spatially heterogeneous surface, net nitrous oxide production is under predicted. We apply this general result in a test of a widely-used global land surface model, the Community Land Model v4.5. The challenges presented by nonlinear controls on nitrous oxide are highlighted here to provide a wider context to the problem of extraordinary denitrification losses in CLM. We hope that these findings will inform future researchers on the possibilities for model improvement of the global nitrogen cycle.

  20. Representing adaptive and adaptable Units of Learning. How to model personalized eLearning in IMS Learning Design

    NARCIS (Netherlands)

    Burgos, Daniel; Tattersall, Colin; Koper, Rob

    2006-01-01

    Burgos, D., Tattersall, C., & Koper, E. J. R. (2007). Representing adaptive and adaptable Units of Learning. How to model personalized eLearning in IMS Learning Design. In B. Fernández Manjon, J. M. Sanchez Perez, J. A. Gómez Pulido, M. A. Vega Rodriguez & J. Bravo (Eds.), Computers and Education:

  1. Representing adaptive and adaptable Units of Learning. How to model personalized eLearning in IMS Learning Design

    OpenAIRE

    Burgos, Daniel; Tattersall, Colin; Koper, Rob

    2006-01-01

    Burgos, D., Tattersall, C., & Koper, E. J. R. (2007). Representing adaptive and adaptable Units of Learning. How to model personalized eLearning in IMS Learning Design. In B. Fernández Manjon, J. M. Sanchez Perez, J. A. Gómez Pulido, M. A. Vega Rodriguez & J. Bravo (Eds.), Computers and Education: E-learning - from theory to practice. Germany: Kluwer.

  2. Peculiarities of inflorescences morphogenesis in model representatives of the Celastraceae R.Br. in context of molecular phylogenetic data

    Directory of Open Access Journals (Sweden)

    Ivan A. Savinov

    2014-04-01

    Full Text Available Peculiarities of laying and forming of inflorescences for model representatives of the Celastraceae are studied. Specific characters in rhythm development of generative elements for different taxa are determined. Morphological markers, which are coincided completely with molecular characters, are determined. They are evidenced on closely relation between next taxa: Celastrus and Tripterygium, Salacia and Sarawakodendron, Salacia and Brexia.

  3. A supply function model for representing the strategic bidding of the producers in constrained electricity markets

    International Nuclear Information System (INIS)

    Bompard, Ettore; Napoli, Roberto; Lu, Wene; Jiang, Xiuchen

    2010-01-01

    The modeling of the bidding behaviour of the producer is a key-point in the modeling and simulation of the competitive electricity markets. In our paper, the linear supply function model is applied so as to find the Supply Function Equilibrium analytically. It also proposed a new and efficient approach to find SFEs for the network constrained electricity markets by finding the best slope of the supply function with the help of changing the intercept, and the method can be applied on the large systems. The approach proposed is applied to study IEEE-118 bus test systems and the comparison between bidding slope and bidding intercept is presented, as well, with reference to the test system. (author)

  4. A model for representing the Italian energy system. The NEEDS-TIMES experience

    Energy Technology Data Exchange (ETDEWEB)

    Cosmi, C.; Pietrapertosa, F.; Salvia, M. [National Research Council, Institute of Methodologies for Environmental Analysis, C.da S. Loja, I-85050 Tito Scalo (PZ) (Italy)]|[Federico II University, Department of Physical Sciences, Via Cintia, I-80126 Naples (Italy); Di Leo, S. [National Research Council, National Institute for the Physics of Matter, Via Cintia, I-80126 Naples (Italy)]|[University of Basilicata, Department of Environmental Engineering and Physics, C.da Macchia Romana, I-85100 Potenza (Italy); Loperte, S.; Cuomo, V. [National Research Council, Institute of Methodologies for Environmental Analysis, C.da S. Loja, I-85050 Tito Scalo (PZ) (Italy); Macchiato, M. [Federico II University, Department of Physical Sciences, Via Cintia, I-80126 Naples (Italy)]|[National Research Council, National Institute for the Physics of Matter, Via Cintia, I-80126 Naples (Italy)

    2009-05-15

    Sustainability of energy systems has a strategic role in the current energy-environmental policies as it involves key issues such as security of energy supply, mitigation of environmental impact (with special regard to air quality improvement) and energy affordability. In this framework modelling activities are more than ever a strategic issue in order to manage the large complexity of energy systems as well as to support the decision-making process at different stages and spatial scales (regional, national, Pan-European, etc.). The aim of this article is to present a new model for the Italian energy system implemented with a common effort in the framework of an integrated project under the Sixth Framework Programme. In particular, the main features of the common methodology are briefly recalled and the modelling structure, the main data and assumptions, sector by sector, are presented. Moreover the main results obtained for the baseline (BAU) scenario are fully described. (author)

  5. Animal models of osteogenesis imperfecta: applications in clinical research

    Directory of Open Access Journals (Sweden)

    Enderli TA

    2016-09-01

    Full Text Available Tanya A Enderli, Stephanie R Burtch, Jara N Templet, Alessandra Carriero Department of Biomedical Engineering, Florida Institute of Technology, Melbourne, FL, USA Abstract: Osteogenesis imperfecta (OI, commonly known as brittle bone disease, is a genetic disease characterized by extreme bone fragility and consequent skeletal deformities. This connective tissue disorder is caused by mutations in the quality and quantity of the collagen that in turn affect the overall mechanical integrity of the bone, increasing its vulnerability to fracture. Animal models of the disease have played a critical role in the understanding of the pathology and causes of OI and in the investigation of a broad range of clinical therapies for the disease. Currently, at least 20 animal models have been officially recognized to represent the phenotype and biochemistry of the 17 different types of OI in humans. These include mice, dogs, and fish. Here, we describe each of the animal models and the type of OI they represent, and present their application in clinical research for treatments of OI, such as drug therapies (ie, bisphosphonates and sclerostin and mechanical (ie, vibrational loading. In the future, different dosages and lengths of treatment need to be further investigated on different animal models of OI using potentially promising treatments, such as cellular and chaperone therapies. A combination of therapies may also offer a viable treatment regime to improve bone quality and reduce fragility in animals before being introduced into clinical trials for OI patients. Keywords: OI, brittle bone, clinical research, mouse, dog, zebrafish

  6. A General Model for Representing Arbitrary Unsymmetries in Various Types of Network Analysis

    DEFF Research Database (Denmark)

    Rønne-Hansen, Jan

    1997-01-01

    When dealing with unsymmetric faults various proposals have been put forward. In general they have been characterized by specific treatment of the single fault in accordance with the structure and impedances involved. The model presented is based on node equations and was originally developed for...... complicated fault situation which has not been treated before for traditional transient stability analysis...

  7. Promoting Preservice Teacher Reflectivity: Van Manen May Represent a Viable Model

    Science.gov (United States)

    Ballard, Kristy K.; McBride, Ron

    2010-01-01

    From Dewey (1933) to present, reflectivity is an important component of teacher education. Little information exists that specifically addresses when changes in reflectivity might occur. Therefore, the purpose of this study was: (a) to apply Van Manen's model to outcomes to examine levels of, and changes in, reflectivity and (b) to verify the…

  8. Challenges of Representing Sub-Grid Physics in an Adaptive Mesh Refinement Atmospheric Model

    Science.gov (United States)

    O'Brien, T. A.; Johansen, H.; Johnson, J. N.; Rosa, D.; Benedict, J. J.; Keen, N. D.; Collins, W.; Goodfriend, E.

    2015-12-01

    Some of the greatest potential impacts from future climate change are tied to extreme atmospheric phenomena that are inherently multiscale, including tropical cyclones and atmospheric rivers. Extremes are challenging to simulate in conventional climate models due to existing models' coarse resolutions relative to the native length-scales of these phenomena. Studying the weather systems of interest requires an atmospheric model with sufficient local resolution, and sufficient performance for long-duration climate-change simulations. To this end, we have developed a new global climate code with adaptive spatial and temporal resolution. The dynamics are formulated using a block-structured conservative finite volume approach suitable for moist non-hydrostatic atmospheric dynamics. By using both space- and time-adaptive mesh refinement, the solver focuses computational resources only where greater accuracy is needed to resolve critical phenomena. We explore different methods for parameterizing sub-grid physics, such as microphysics, macrophysics, turbulence, and radiative transfer. In particular, we contrast the simplified physics representation of Reed and Jablonowski (2012) with the more complex physics representation used in the System for Atmospheric Modeling of Khairoutdinov and Randall (2003). We also explore the use of a novel macrophysics parameterization that is designed to be explicitly scale-aware.

  9. Representing northern peatland microtopography and hydrology within the Community Land Model

    Science.gov (United States)

    X. Shi; P.E. Thornton; D.M. Ricciuto; P J. Hanson; J. Mao; Stephen Sebestyen; N.A. Griffiths; G. Bisht

    2015-01-01

    Predictive understanding of northern peatland hydrology is a necessary precursor to understanding the fate of massive carbon stores in these systems under the influence of present and future climate change. Current models have begun to address microtopographic controls on peatland hydrology, but none have included a prognostic calculation of peatland water table depth...

  10. Explaining clinical behaviors using multiple theoretical models

    OpenAIRE

    Eccles, Martin P; Grimshaw, Jeremy M; MacLennan, Graeme; Bonetti, Debbie; Glidewell, Liz; Pitts, Nigel B; Steen, Nick; Thomas, Ruth; Walker, Anne; Johnston, Marie

    2012-01-01

    Abstract Background In the field of implementation research, there is an increased interest in use of theory when designing implementation research studies involving behavior change. In 2003, we initiated a series of five studies to establish a scientific rationale for interventions to translate research findings into clinical practice by exploring the performance of a number of different, commonly used, overlapping behavioral theories and models. We reflect on the strengths and weaknesses of...

  11. Clinical presentation of hyperthyroidism in a large representative sample of outpatients in France: relationships with age, aetiology and hormonal parameters.

    Science.gov (United States)

    Goichot, B; Caron, Ph; Landron, F; Bouée, S

    2016-03-01

    Signs and symptoms of thyrotoxicosis are not specific, and thyroid function tests are frequently prescribed to recognize such thyroid dysfunction. Ultrasensitive assays of thyroid-stimulating hormone (TSH) allow early diagnosis and identification of mild hyperthyroidism (generally designed as 'subclinical'). The aim of this study was to re-evaluate the clinical picture of thyrotoxicosis in the context of the current large utilization of ultrasensitive TSH assays. Prospective descriptive cohort. Clinical presentation of 1572 patients with a recent (symptoms, hormonal evaluation and treatment. A total of 1240 (78·9%) patients were women, mean age 48 ± 17 years. Subclinical hyperthyroidism (SCHT) was present in 86 patients (10·4%). Symptoms of thyrotoxicosis were in decreasing frequency order: palpitations, weakness, heat-related signs and disturbed sleep. A total of 64·9% of patients had lost weight. Signs and symptoms were more frequent in Graves' disease, in young patients, and were partially related to biochemical severity. Symptoms were less frequent in elderly patients except for cardiac manifestations (atrial fibrillation). Most patients with SCHT had one or several signs or symptoms of thyrotoxicosis. This study confirms that elderly patients have less symptoms of thyrotoxicosis than younger subjects but are at increased risk of cardiac complications. Our results show that most patients with 'subclinical' HT have in fact signs or symptoms of thyrotoxicosis. © 2015 John Wiley & Sons Ltd.

  12. Use of CFD modeling for estimating spatial representativeness of urban air pollution monitoring sites and suitability of their locations

    International Nuclear Information System (INIS)

    Santiago, J. L.; Martin, F.

    2015-01-01

    A methodology to estimate the spatial representativeness of air pollution monitoring sites is applied to two urban districts. This methodology is based on high resolution maps of air pollution computed by using Computational Fluid Dynamics (CFD) modelling tools. Traffic-emitted NO 2 dispersion is simulated for several meteorological conditions taking into account the effect of the buildings on air flow and pollutant dispersion and using a steady state CFD-RANS approach. From these results, maps of average pollutant concentrations for January -May 2011 are computed as a combination of the simulated scenarios. Two urban districts of Madrid City were simulated. Spatial representativeness areas for 32 different sites within the same district (including the site of the operative air quality stations) have been estimated by computing the portion of the domains with average NO 2 concentration differing less than a 20% of the concentration at each candidate monitoring site. New parameters such as the ratio AR between the representativeness area and the whole domain area or the representativeness index (IR) has been proposed to discuss and compare the representativeness areas. Significant differences between the spatial representativeness of the candidate sites of both studied districts have been found. The sites of the Escuelas Aguirre district have generally smaller representativeness areas than those of the Plaza de Castilla. More stations are needed to cover the Escuelas Aguirre district than for the Plaza de Castilla one. The operative air quality station of the Escuelas Aguirre district is less representative than the station of the Plaza de Castilla district. The cause of these differences seems to be the differences in urban structure of both districts prompting different ventilation. (Author)

  13. Use of CFD modeling for estimating spatial representativeness of urban air pollution monitoring sites and suitability of their locations

    Energy Technology Data Exchange (ETDEWEB)

    Santiago, J. L.; Martin, F.

    2015-07-01

    A methodology to estimate the spatial representativeness of air pollution monitoring sites is applied to two urban districts. This methodology is based on high resolution maps of air pollution computed by using Computational Fluid Dynamics (CFD) modelling tools. Traffic-emitted NO{sub 2} dispersion is simulated for several meteorological conditions taking into account the effect of the buildings on air flow and pollutant dispersion and using a steady state CFD-RANS approach. From these results, maps of average pollutant concentrations for January -May 2011 are computed as a combination of the simulated scenarios. Two urban districts of Madrid City were simulated. Spatial representativeness areas for 32 different sites within the same district (including the site of the operative air quality stations) have been estimated by computing the portion of the domains with average NO{sub 2} concentration differing less than a 20% of the concentration at each candidate monitoring site. New parameters such as the ratio AR between the representativeness area and the whole domain area or the representativeness index (IR) has been proposed to discuss and compare the representativeness areas. Significant differences between the spatial representativeness of the candidate sites of both studied districts have been found. The sites of the Escuelas Aguirre district have generally smaller representativeness areas than those of the Plaza de Castilla. More stations are needed to cover the Escuelas Aguirre district than for the Plaza de Castilla one. The operative air quality station of the Escuelas Aguirre district is less representative than the station of the Plaza de Castilla district. The cause of these differences seems to be the differences in urban structure of both districts prompting different ventilation. (Author)

  14. Use of CFD modeling for estimating spatial representativeness of urban air pollution monitoring sites and suitability of their locations

    Energy Technology Data Exchange (ETDEWEB)

    Santiago, J.L.; Martin, F.

    2015-07-01

    A methodology to estimate the spatial representativeness of air pollution monitoring sites is applied to two urban districts. This methodology is based on high resolution maps of air pollution computed by using Computational Fluid Dynamics (CFD) modelling tools. Traffic-emitted NO2 dispersion is simulated for several meteorological conditions taking into account the effect of the buildings on air flow and pollutant dispersion and using a steady state CFD-RANS approach. From these results, maps of average pollutant concentrations for January–May 2011 are computed as a combination of the simulated scenarios. Two urban districts of Madrid City were simulated. Spatial representativeness areas for 32 different sites within the same district (including the site of the operative air quality stations) have been estimated by computing the portion of the domains with average NO2 concentration differing less than a 20% of the concentration at each candidate monitoring site. New parameters such as the ratio AR between the representativeness area and the whole domain area or the representativeness index (IR) has been proposed to discuss and compare the representativeness areas. Significant differences between the spatial representativeness of the candidate sites of both studied districts have been found. The sites of the Escuelas Aguirre district have generally smaller representativeness areas than those of the Plaza de Castilla. More stations are needed to cover the Escuelas Aguirre district than for the Plaza de Castilla one. The operative air quality station of the Escuelas Aguirre district is less representative than the station of the Plaza de Castilla district. The cause of these differences seems to be the differences in urban structure of both districts prompting different ventilation. (Author)

  15. Final Technical Report: "Representing Endogenous Technological Change in Climate Policy Models: General Equilibrium Approaches"

    Energy Technology Data Exchange (ETDEWEB)

    Ian Sue Wing

    2006-04-18

    The research supported by this award pursued three lines of inquiry: (1) The construction of dynamic general equilibrium models to simulate the accumulation and substitution of knowledge, which has resulted in the preparation and submission of several papers: (a) A submitted pedagogic paper which clarifies the structure and operation of computable general equilibrium (CGE) models (C.2), and a review article in press which develops a taxonomy for understanding the representation of technical change in economic and engineering models for climate policy analysis (B.3). (b) A paper which models knowledge directly as a homogeneous factor, and demonstrates that inter-sectoral reallocation of knowledge is the key margin of adjustment which enables induced technical change to lower the costs of climate policy (C.1). (c) An empirical paper which estimates the contribution of embodied knowledge to aggregate energy intensity in the U.S. (C.3), followed by a companion article which embeds these results within a CGE model to understand the degree to which autonomous energy efficiency improvement (AEEI) is attributable to technical change as opposed to sub-sectoral shifts in industrial composition (C.4) (d) Finally, ongoing theoretical work to characterize the precursors and implications of the response of innovation to emission limits (E.2). (2) Data development and simulation modeling to understand how the characteristics of discrete energy supply technologies determine their succession in response to emission limits when they are embedded within a general equilibrium framework. This work has produced two peer-reviewed articles which are currently in press (B.1 and B.2). (3) Empirical investigation of trade as an avenue for the transmission of technological change to developing countries, and its implications for leakage, which has resulted in an econometric study which is being revised for submission to a journal (E.1). As work commenced on this topic, the U.S. withdrawal

  16. Developing Mesoscale Model of Fibrin-Platelet Network Representing Blood Clotting =

    Science.gov (United States)

    Sun, Yueyi; Nikolov, Svetoslav; Bowie, Sam; Alexeev, Alexander; Lam, Wilbur; Myers, David

    Blood clotting disorders which prevent the body's natural ability to achieve hemostasis can lead to a variety of life threatening conditions such as, excessive bleeding, stroke, or heart attack. Treatment of these disorders is highly dependent on understanding the underlying physics behind the clotting process. Since clotting is a highly complex multi scale mechanism developing a fully atomistic model is currently not possible. We develop a mesoscale model based on dissipative particle dynamics (DPD) to gain fundamental understanding of the underlying principles controlling the clotting process. In our study, we examine experimental data on clot contraction using stacks of confocal microscopy images to estimate the crosslink density in the fibrin networks and platelet location. Using this data we reconstruct the platelet rich fibrin network and study how platelet-fibrin interactions affect clotting. Furthermore, we probe how different system parameters affect clot contraction. ANSF CAREER Award DMR-1255288.

  17. Towards representing human behavior and decision making in Earth system models - an overview of techniques and approaches

    Science.gov (United States)

    Müller-Hansen, Finn; Schlüter, Maja; Mäs, Michael; Donges, Jonathan F.; Kolb, Jakob J.; Thonicke, Kirsten; Heitzig, Jobst

    2017-11-01

    Today, humans have a critical impact on the Earth system and vice versa, which can generate complex feedback processes between social and ecological dynamics. Integrating human behavior into formal Earth system models (ESMs), however, requires crucial modeling assumptions about actors and their goals, behavioral options, and decision rules, as well as modeling decisions regarding human social interactions and the aggregation of individuals' behavior. Here, we review existing modeling approaches and techniques from various disciplines and schools of thought dealing with human behavior at different levels of decision making. We demonstrate modelers' often vast degrees of freedom but also seek to make modelers aware of the often crucial consequences of seemingly innocent modeling assumptions. After discussing which socioeconomic units are potentially important for ESMs, we compare models of individual decision making that correspond to alternative behavioral theories and that make diverse modeling assumptions about individuals' preferences, beliefs, decision rules, and foresight. We review approaches to model social interaction, covering game theoretic frameworks, models of social influence, and network models. Finally, we discuss approaches to studying how the behavior of individuals, groups, and organizations can aggregate to complex collective phenomena, discussing agent-based, statistical, and representative-agent modeling and economic macro-dynamics. We illustrate the main ingredients of modeling techniques with examples from land-use dynamics as one of the main drivers of environmental change bridging local to global scales.

  18. Representative Structural Element - A New Paradigm for Multi-Scale Structural Modeling

    Science.gov (United States)

    2016-07-05

    9,10,11]. Prof. Yu was invited to give a seminar with the same title of this project at AFRL WPAFB (Nov. 4, 2013). The host is Dr. Steve Clay of...Aerospace System Directorate. Prof. Yu also had frequent interaction with Dr. Clay regarding damage modeling of composite laminates. He has kindly... viscosity parameter is adopted to yield close predictions of the specimen responses. The load rate and the specimen mass density are properly selected to

  19. A Hidden Markov Model Representing the Spatial and Temporal Correlation of Multiple Wind Farms

    DEFF Research Database (Denmark)

    Fang, Jiakun; Su, Chi; Hu, Weihao

    2015-01-01

    To accommodate the increasing wind energy with stochastic nature becomes a major issue on power system reliability. This paper proposes a methodology to characterize the spatiotemporal correlation of multiple wind farms. First, a hierarchical clustering method based on self-organizing maps is ado....... The proposed statistical modeling framework is compatible with the sequential power system reliability analysis. A case study on optimal sizing and location of fast-response regulation sources is presented.......To accommodate the increasing wind energy with stochastic nature becomes a major issue on power system reliability. This paper proposes a methodology to characterize the spatiotemporal correlation of multiple wind farms. First, a hierarchical clustering method based on self-organizing maps...... is adopted to categorize the similar output patterns of several wind farms into joint states. Then the hidden Markov model (HMM) is then designed to describe the temporal correlations among these joint states. Unlike the conventional Markov chain model, the accumulated wind power is taken into consideration...

  20. Representing Development

    DEFF Research Database (Denmark)

    Representing Development presents the different social representations that have formed the idea of development in Western thinking over the past three centuries. Offering an acute perspective on the current state of developmental science and providing constructive insights into future pathways, ...

  1. Coaching Model + Clinical Playbook = Transformative Learning.

    Science.gov (United States)

    Fletcher, Katherine A; Meyer, Mary

    2016-01-01

    Health care employers demand that workers be skilled in clinical reasoning, able to work within complex interprofessional teams to provide safe, quality patient-centered care in a complex evolving system. To this end, there have been calls for radical transformation of nursing education including the development of a baccalaureate generalist nurse. Based on recommendations from the American Association of Colleges of Nursing, faculty concluded that clinical education must change moving beyond direct patient care by applying the concepts associated with designer, manager, and coordinator of care and being a member of a profession. To accomplish this, the faculty utilized a system of focused learning assignments (FLAs) that present transformative learning opportunities that expose students to "disorienting dilemmas," alternative perspectives, and repeated opportunities to reflect and challenge their own beliefs. The FLAs collected in a "Playbook" were scaffolded to build the student's competencies over the course of the clinical experience. The FLAs were centered on the 6 Quality and Safety Education for Nurses competencies, with 2 additional concepts of professionalism and systems-based practice. The FLAs were competency-based exercises that students performed when not assigned to direct patient care or had free clinical time. Each FLA had a lesson plan that allowed the student and faculty member to see the competency addressed by the lesson, resources, time on task, student instructions, guide for reflection, grading rubric, and recommendations for clinical instructor. The major advantages of the model included (a) consistent implementation of structured learning experiences by a diverse teaching staff using a coaching model of instruction; (b) more systematic approach to present learning activities that build upon each other; (c) increased time for faculty to interact with students providing direct patient care; (d) guaranteed capture of selected transformative

  2. Assessing sample representativeness in randomized controlled trials: application to the National Institute of Drug Abuse Clinical Trials Network.

    Science.gov (United States)

    Susukida, Ryoko; Crum, Rosa M; Stuart, Elizabeth A; Ebnesajjad, Cyrus; Mojtabai, Ramin

    2016-07-01

    To compare the characteristics of individuals participating in randomized controlled trials (RCTs) of treatments of substance use disorder (SUD) with individuals receiving treatment in usual care settings, and to provide a summary quantitative measure of differences between characteristics of these two groups of individuals using propensity score methods. Design Analyses using data from RCT samples from the National Institute of Drug Abuse Clinical Trials Network (CTN) and target populations of patients drawn from the Treatment Episodes Data Set-Admissions (TEDS-A). Settings Multiple clinical trial sites and nation-wide usual SUD treatment settings in the United States. A total of 3592 individuals from 10 CTN samples and 1 602 226 individuals selected from TEDS-A between 2001 and 2009. Measurements The propensity scores for enrolling in the RCTs were computed based on the following nine observable characteristics: sex, race/ethnicity, age, education, employment status, marital status, admission to treatment through criminal justice, intravenous drug use and the number of prior treatments. Findings The proportion of those with ≥ 12 years of education and the proportion of those who had full-time jobs were significantly higher among RCT samples than among target populations (in seven and nine trials, respectively, at P difference in the mean propensity scores between the RCTs and the target population was 1.54 standard deviations and was statistically significant at P different from individuals receiving treatment in usual care settings. Notably, RCT participants tend to have more years of education and a greater likelihood of full-time work compared with people receiving care in usual care settings. © 2016 Society for the Study of Addiction.

  3. Representing Misalignments of the STAR Geometry Model using AgML

    Science.gov (United States)

    Webb, Jason C.; Lauret, Jérôme; Perevotchikov, Victor; Smirnov, Dmitri; Van Buren, Gene

    2017-10-01

    The STAR Heavy Flavor Tracker (HFT) was designed to provide high-precision tracking for the identification of charmed hadron decays in heavy-ion collisions at RHIC. It consists of three independently mounted subsystems, providing four precision measurements along the track trajectory, with the goal of pointing decay daughters back to vertices displaced by less than 100 microns from the primary event vertex. The ultimate efficiency and resolution of the physics analysis will be driven by the quality of the simulation and reconstruction of events in heavy-ion collisions. In particular, it is important that the geometry model properly accounts for the relative misalignments of the HFT subsystems, along with the alignment of the HFT relative to STARs primary tracking detector, the Time Projection Chamber (TPC). The Abstract Geometry Modeling Language (AgML) provides a single description of the STAR geometry, generating both our simulation (GEANT 3) and reconstruction geometries (ROOT). AgML implements an ideal detector model, while misalignments are stored separately in database tables. These have historically been applied at the hit level. Simulated detector hits are projected from their ideal position along the track’s trajectory, until they intersect the misaligned detector volume, where the struck detector element is calculated for hit digitization. This scheme has worked well as hit errors have been negligible compared with the size of sensitive volumes. The precision and complexity of the HFT detector require us to apply misalignments to the detector volumes themselves. In this paper we summarize the extension of the AgML language and support libraries to enable the static misalignment of our reconstruction and simulation geometries, discussing the design goals, limitations and path to full misalignment support in ROOT/VMC-based simulation.

  4. RIPH: A Model for Representing the Reality in the Global and Local Television

    Directory of Open Access Journals (Sweden)

    Saket Hosseynov

    2013-03-01

    Full Text Available The world is witnessing great changes, and these changes are comprehensible in the realm of performance of "identity", "boundary", "geographic concept” (place and "time". Identities are now segmented, boundaries passed over, and places and time compressed. Television is one of the effective factors in making this happen. However, it seems like television, which itself is one of the evidences of globalization, has now acquired new characteristics. With a little care while reading texts related to globalization and media, we realize the four words "reality", "identity", "power" and "hyper-reality" are constantly repeated in these texts, and very few people doubt the close relationship between television and these topics. Facing such a situation, and to understand the characteristics of the global television, this article plans to start on the basis of a theoretic called "RIPH Model". Based on the presumption that the role and place of television in forming the cultural shapes must not be exaggerated, it tries to present an outlook of the activities of the local and global televisions in the age of globalization and share the outcomes with 20 Iranian experts through interviews. RIPH is the short form which stands for the four words "reality", "identity", "power" and "hyper-reality". These are the concepts with new definitions that have changed our views about life on the Planet Earth, and this article studies the factors related to global and local televisions in the frame of an innovative model suggested by the researcher called "The Lozenge of the Performance of the Global and Local Televisions (RIPH Model", by investigating the relations between television and the above-mentioned concepts.

  5. A comparison of methods for representing random taste heterogeneity in discrete choice models

    DEFF Research Database (Denmark)

    Fosgerau, Mogens; Hess, Stephane

    2009-01-01

    This paper reports the findings of a systematic study using Monte Carlo experiments and a real dataset aimed at comparing the performance of various ways of specifying random taste heterogeneity in a discrete choice model. Specifically, the analysis compares the performance of two recent advanced...... distributions. Both approaches allow the researcher to increase the number of parameters as desired. The paper provides a range of evidence on the ability of the various approaches to recover various distributions from data. The two advanced approaches are comparable in terms of the likelihoods achieved...

  6. Representing biophysical landscape interactions in soil models by bridging disciplines and scales.

    Science.gov (United States)

    van der Ploeg, M. J.; Carranza, C.; Teixeira da Silva, R.; te Brake, B.; Baartman, J.; Robinson, D.

    2017-12-01

    The combination of climate change, population growth and soil threats including carbon loss, biodiversity decline and erosion, increasingly confront the global community (Schwilch et al., 2016). One major challenge in studying processes involved in soil threats, landscape resilience, ecosystem stability, sustainable land management and resulting economic consequences, is that it is an interdisciplinary field (Pelletier et al., 2012). Less stringent scientific disciplinary boundaries are therefore important (Liu et al., 2007), because as a result of disciplinary focus, ambiguity may arise on the understanding of landscape interactions. This is especially true in the interaction between a landscape's physical and biological processes (van der Ploeg et al. 2012). Biophysical landscape interactions are those biotic and abiotic processes in a landscape that have an influence on the developments within and evolution of a landscape. An important aspect in biophysical landscape interactions is the differences in scale related to the various processes that play a role in these systems. Moreover, the interplay between the physical landscape and the occurring vegetation, which often co-evolve, and the resulting heterogeneity and emerging patterns are the reason why it is so challenging to establish a theoretical basis to describe biophysical processes in landscapes (e.g. te Brake et al. 2013, Robinson et al. 2016). Another complicating factor is the response of vegetation to changing environmental conditions, including a possible, and often unknown, time-lag (e.g. Metzger et al., 2009). An integrative description for modelling biophysical interactions has been a long standing goal in soil science (Vereecken et al., 2016). We need the development of soil models that are more focused on networks, connectivity and feedbacks incorporating the most important aspects of our detailed mechanistic modelling (Paola & Leeder, 2011). Additionally, remote sensing measurement techniques

  7. Two-fluid model of the pulsar magnetosphere represented as an axisymmetric force-free dipole

    Energy Technology Data Exchange (ETDEWEB)

    Petrova, S.A., E-mail: petrova@rian.kharkov.ua [Institute of Radio Astronomy of the NAS of Ukraine, Mystetstv Str., 4, Kharkiv 61002 (Ukraine)

    2017-05-01

    Based on the exact dipolar solution of the pulsar equation the self-consistent two-fluid model of the pulsar magnetosphere is developed. We concentrate on the low-mass limit of the model, taking into account the radiation damping. As a result, we obtain the particle distributions sustaining the dipolar force-free configuration of the pulsar magnetosphere in case of a slight velocity shear of the electron and positron components. Over most part of the force-free region, the particles follow the poloidal magnetic field lines, with the azimuthal velocities being small. Close to the Y-point, however, the particle motion is chiefly azimuthal and the Lorentz-factor grows unrestrictedly. This may result in the very-high-energy emission from the vicinity of the Y-point and may also imply the magnetocentrifugal formation of a jet. As for the first-order quantities, the longitudinal accelerating electric field is found to change the sign, hinting at coexistence of the polar and outer gaps. Besides that, the components of the plasma conductivity tensor are derived and the low-mass analogue of the pulsar equation is formulated as well.

  8. Representing Glaciations and Subglacial Processes in Hydrogeological Models: A Numerical Investigation

    Directory of Open Access Journals (Sweden)

    Arnaud Sterckx

    2017-01-01

    Full Text Available The specific impact of glacial processes on groundwater flow and solute transport under ice-sheets was determined by means of numerical simulations. Groundwater flow and the transport of δ18O, TDS, and groundwater age were simulated in a generic sedimentary basin during a single glacial event followed by a postglacial period. Results show that simulating subglacial recharge with a fixed flux boundary condition is relevant only for small fluxes, which could be the case under partially wet-based ice-sheets. Glacial loading decreases overpressures, which appear only in thick and low hydraulic diffusivity layers. If subglacial recharge is low, glacial loading can lead to underpressures after the retreat of the ice-sheet. Isostasy reduces considerably the infiltration of meltwater and the groundwater flow rates. Below permafrost, groundwater flow is reduced under the ice-sheet but is enhanced beyond the ice-sheet front. Accounting for salinity-dependent density reduces the infiltration of meltwater at depth. This study shows that each glacial process is potentially relevant in models of subglacial groundwater flow and solute transport. It provides a good basis for building and interpreting such models in the future.

  9. The SHOCT domain: a widespread domain under-represented in model organisms.

    Directory of Open Access Journals (Sweden)

    Ruth Y Eberhardt

    Full Text Available We have identified a new protein domain, which we have named the SHOCT domain (Short C-terminal domain. This domain is widespread in bacteria with over a thousand examples. But we found it is missing from the most commonly studied model organisms, despite being present in closely related species. It's predominantly C-terminal location, co-occurrence with numerous other domains and short size is reminiscent of the Gram-positive anchor motif, however it is present in a much wider range of species. We suggest several hypotheses about the function of SHOCT, including oligomerisation and nucleic acid binding. Our initial experiments do not support its role as an oligomerisation domain.

  10. New Media and Models for Engaging Under-Represented Students in Science

    Science.gov (United States)

    Mayhew, Laurel M.; Finkelstein, Noah D.

    2008-10-01

    We describe the University of Colorado Partnerships for Informal Science Education in the Community (PISEC) program in which university students participate in classroom and after school science activities with local precollege children. Across several different formal and informal educational environments, we use new technological tools, such as stop action motion (SAM) movies [1] to engage children so that they may develop an understanding of science through play and "show and tell". This approach provides a complementary avenue for reaching children who are otherwise underrepresented in science and under-supported in more formal educational settings. We present the model of university community partnership and demonstrate its utility in a case study involving an African American third grade student learning about velocity and acceleration.

  11. A spring-mass-damper system dynamics-based driver-vehicle integrated model for representing heterogeneous traffic

    Science.gov (United States)

    Munigety, Caleb Ronald

    2018-04-01

    The traditional traffic microscopic simulation models consider driver and vehicle as a single unit to represent the movements of drivers in a traffic stream. Due to this very fact, the traditional car-following models have the driver behavior related parameters, but ignore the vehicle related aspects. This approach is appropriate for homogeneous traffic conditions where car is the major vehicle type. However, in heterogeneous traffic conditions where multiple vehicle types are present, it becomes important to incorporate the vehicle related parameters exclusively to account for the varying dynamic and static characteristics. Thus, this paper presents a driver-vehicle integrated model hinged on the principles involved in physics-based spring-mass-damper mechanical system. While the spring constant represents the driver’s aggressiveness, the damping constant and the mass component take care of the stability and size/weight related aspects, respectively. The proposed model when tested, behaved pragmatically in representing the vehicle-type dependent longitudinal movements of vehicles.

  12. Radiation repair models for clinical application.

    Science.gov (United States)

    Dale, Roger G

    2018-02-28

    A number of newly emerging clinical techniques involve non-conventional patterns of radiation delivery which require an appreciation of the role played by radiation repair phenomena. This review outlines the main models of radiation repair, focussing on those which are of greatest clinical usefulness and which may be incorporated into biologically effective dose assessments. The need to account for the apparent "slowing-down" of repair rates observed in some normal tissues is also examined, along with a comparison of the relative merits of the formulations which can be used to account for such phenomena. Jack Fowler brought valuable insight to the understanding of radiation repair processes and this article includes reference to his important contributions in this area.

  13. Kidney transplantation process in Brazil represented in business process modeling notation.

    Science.gov (United States)

    Peres Penteado, A; Molina Cohrs, F; Diniz Hummel, A; Erbs, J; Maciel, R F; Feijó Ortolani, C L; de Aguiar Roza, B; Torres Pisa, I

    2015-05-01

    Kidney transplantation is considered to be the best treatment for people with chronic kidney failure, because it improves the patients' quality of life and increases their length of survival compared with patients undergoing dialysis. The kidney transplantation process in Brazil is defined through laws, decrees, ordinances, and resolutions, but there is no visual representation of this process. The aim of this study was to analyze official documents to construct a representation of the kidney transplantation process in Brazil with the use of business process modeling notation (BPMN). The methodology for this study was based on an exploratory observational study, document analysis, and construction of process diagrams with the use of BPMN. Two rounds of validations by specialists were conducted. The result includes the kidney transplantation process in Brazil representation with the use of BPMN. We analyzed 2 digital documents that resulted in 2 processes with 45 total of activities and events, 6 organizations involved, and 6 different stages of the process. The constructed representation makes it easier to understand the rules for the business of kidney transplantation and can be used by the health care professionals involved in the various activities within this process. Construction of a representation with language appropriate for the Brazilian lay public is underway. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. From representing to modelling knowledge: Proposing a two-step training for excellence in concept mapping

    Directory of Open Access Journals (Sweden)

    Joana G. Aguiar

    2017-09-01

    Full Text Available Training users in the concept mapping technique is critical for ensuring a high-quality concept map in terms of graphical structure and content accuracy. However, assessing excellence in concept mapping through structural and content features is a complex task. This paper proposes a two-step sequential training in concept mapping. The first step requires the fulfilment of low-order cognitive objectives (remember, understand and apply to facilitate novices’ development into good Cmappers by honing their knowledge representation skills. The second step requires the fulfilment of high-order cognitive objectives (analyse, evaluate and create to grow good Cmappers into excellent ones through the development of knowledge modelling skills. Based on Bloom’s revised taxonomy and cognitive load theory, this paper presents theoretical accounts to (1 identify the criteria distinguishing good and excellent concept maps, (2 inform instructional tasks for concept map elaboration and (3 propose a prototype for training users on concept mapping combining online and face-to-face activities. The proposed training application and the institutional certification are the next steps for the mature use of concept maps for educational as well as business purposes.

  15. Triangular model integrating clinical teaching and assessment

    Directory of Open Access Journals (Sweden)

    Abdelaziz A

    2014-03-01

    Full Text Available Adel Abdelaziz,1,2 Emad Koshak3 1Medical Education Development Unit, Faculty of Medicine, Al Baha University, Al Baha, Saudi Arabia; 2Medical Education Department, Faculty of Medicine, Suez Canal University, Egypt; 3Dean and Internal Medicine Department, Faculty of Medicine, Al Baha University, Al Baha, Saudi Arabia Abstract: Structuring clinical teaching is a challenge facing medical education curriculum designers. A variety of instructional methods on different domains of learning are indicated to accommodate different learning styles. Conventional methods of clinical teaching, like training in ambulatory care settings, are prone to the factor of coincidence in having varieties of patient presentations. Accordingly, alternative methods of instruction are indicated to compensate for the deficiencies of these conventional methods. This paper presents an initiative that can be used to design a checklist as a blueprint to guide appropriate selection and implementation of teaching/learning and assessment methods in each of the educational courses and modules based on educational objectives. Three categories of instructional methods were identified, and within each a variety of methods were included. These categories are classroom-type settings, health services-based settings, and community service-based settings. Such categories have framed our triangular model of clinical teaching and assessment. Keywords: curriculum development, teaching, learning, assessment, apprenticeship, community-based settings, health service-based settings

  16. Treatment of Events Representing System Success in Accident Sequences in PSA Models with ET/FT Linking

    International Nuclear Information System (INIS)

    Vrbanic, I.; Spiler, J.; Mikulicic, V.; Simic, Z.

    2002-01-01

    Treatment of events that represent systems' successes in accident sequences is well known issue associated primarily with those PSA models that employ event tree / fault tree (ET / FT) linking technique. Even theoretically clear, practical implementation and usage creates for certain PSA models a number of difficulties regarding result correctness. Strict treatment of success-events would require consistent applying of de Morgan laws. However, there are several problems related to it. First, Boolean resolution of the overall model, such as the one representing occurrence of reactor core damage, becomes very challenging task if De Morgan rules are applied consistently at all levels. Even PSA tools of the newest generation have some problems with performing such a task in a reasonable time frame. The second potential issue is related to the presence of negated basic events in minimal cutsets. If all the basic events that result from strict applying of De Morgan rules are retained in presentation of minimal cutsets, their readability and interpretability may be impaired severely. It is also worth noting that the concept of a minimal cutset is tied to equipment failures, rather than to successes. For reasons like these, various simplifications are employed in PSA models and tools, when it comes to the treatment of success-events in the sequences. This paper provides a discussion of major concerns associated with the treatment of success-events in accident sequences of a typical PSA model. (author)

  17. Representing time

    Directory of Open Access Journals (Sweden)

    Luca Poncellini

    2010-06-01

    Full Text Available The analysis of natural phenomena applied to architectural planning and design is facing the most fascinating and elusive of the four dimensions through which man attempts to define life within the universe: time. We all know what time is, said St. Augustine, but nobody knows how to describe it. Within architectural projects and representations, time rarely appears in explicit form. This paper presents the results of a research conducted by students of NABA and of the Polytechnic of Milan with the purpose of representing time considered as a key element within architectural projects. Student investigated new approaches and methodologies to represent time using the two-dimensional support of a sheet of paper.

  18. The Interaction Network Ontology-supported modeling and mining of complex interactions represented with multiple keywords in biomedical literature.

    Science.gov (United States)

    Özgür, Arzucan; Hur, Junguk; He, Yongqun

    2016-01-01

    hierarchical display of these 34 interaction types and their ancestor terms in INO resulted in the identification of specific gene-gene interaction patterns from the LLL dataset. The phenomenon of having multi-keyword interaction types was also frequently observed in the vaccine dataset. By modeling and representing multiple textual keywords for interaction types, the extended INO enabled the identification of complex biological gene-gene interactions represented with multiple keywords.

  19. [From clinical judgment to linear regression model.

    Science.gov (United States)

    Palacios-Cruz, Lino; Pérez, Marcela; Rivas-Ruiz, Rodolfo; Talavera, Juan O

    2013-01-01

    When we think about mathematical models, such as linear regression model, we think that these terms are only used by those engaged in research, a notion that is far from the truth. Legendre described the first mathematical model in 1805, and Galton introduced the formal term in 1886. Linear regression is one of the most commonly used regression models in clinical practice. It is useful to predict or show the relationship between two or more variables as long as the dependent variable is quantitative and has normal distribution. Stated in another way, the regression is used to predict a measure based on the knowledge of at least one other variable. Linear regression has as it's first objective to determine the slope or inclination of the regression line: Y = a + bx, where "a" is the intercept or regression constant and it is equivalent to "Y" value when "X" equals 0 and "b" (also called slope) indicates the increase or decrease that occurs when the variable "x" increases or decreases in one unit. In the regression line, "b" is called regression coefficient. The coefficient of determination (R 2 ) indicates the importance of independent variables in the outcome.

  20. Land surface temperature representativeness in a heterogeneous area through a distributed energy-water balance model and remote sensing data

    Directory of Open Access Journals (Sweden)

    C. Corbari

    2010-10-01

    Full Text Available Land surface temperature is the link between soil-vegetation-atmosphere fluxes and soil water content through the energy water balance. This paper analyses the representativeness of land surface temperature (LST for a distributed hydrological water balance model (FEST-EWB using LST from AHS (airborne hyperspectral scanner, with a spatial resolution between 2–4 m, LST from MODIS, with a spatial resolution of 1000 m, and thermal infrared radiometric ground measurements that are compared with the representative equilibrium temperature that closes the energy balance equation in the distributed hydrological model.

    Diurnal and nocturnal images are analyzed due to the non stable behaviour of the thermodynamic temperature and to the non linear effects induced by spatial heterogeneity.

    Spatial autocorrelation and scale of fluctuation of land surface temperature from FEST-EWB and AHS are analysed at different aggregation areas to better understand the scale of representativeness of land surface temperature in a hydrological process.

    The study site is the agricultural area of Barrax (Spain that is a heterogeneous area with a patchwork of irrigated and non irrigated vegetated fields and bare soil. The used data set was collected during a field campaign from 10 to 15 July 2005 in the framework of the SEN2FLEX project.

  1. A linear programming approach to reconstructing subcellular structures from confocal images for automated generation of representative 3D cellular models.

    Science.gov (United States)

    Wood, Scott T; Dean, Brian C; Dean, Delphine

    2013-04-01

    This paper presents a novel computer vision algorithm to analyze 3D stacks of confocal images of fluorescently stained single cells. The goal of the algorithm is to create representative in silico model structures that can be imported into finite element analysis software for mechanical characterization. Segmentation of cell and nucleus boundaries is accomplished via standard thresholding methods. Using novel linear programming methods, a representative actin stress fiber network is generated by computing a linear superposition of fibers having minimum discrepancy compared with an experimental 3D confocal image. Qualitative validation is performed through analysis of seven 3D confocal image stacks of adherent vascular smooth muscle cells (VSMCs) grown in 2D culture. The presented method is able to automatically generate 3D geometries of the cell's boundary, nucleus, and representative F-actin network based on standard cell microscopy data. These geometries can be used for direct importation and implementation in structural finite element models for analysis of the mechanics of a single cell to potentially speed discoveries in the fields of regenerative medicine, mechanobiology, and drug discovery. Copyright © 2012 Elsevier B.V. All rights reserved.

  2. A scenario analysis of future energy systems based on an energy flow model represented as functionals of technology options

    International Nuclear Information System (INIS)

    Kikuchi, Yasunori; Kimura, Seiichiro; Okamoto, Yoshitaka; Koyama, Michihisa

    2014-01-01

    Highlights: • Energy flow model was represented as the functionals of technology options. • Relationships among available technologies can be visualized by developed model. • Technology roadmapping can be incorporated into the model as technical scenario. • Combination of technologies can increase their contribution to the environment. - Abstract: The design of energy systems has become an issue all over the world. A single optimal system cannot be suggested because the availability of infrastructure and resources and the acceptability of the system should be discussed locally, involving all related stakeholders in the energy system. In particular, researchers and engineers of technologies related to energy systems should be able to perform the forecasting and roadmapping of future energy systems and indicate quantitative results of scenario analyses. We report an energy flow model developed for analysing scenarios of future Japanese energy systems implementing a variety of feasible technology options. The model was modularized and represented as functionals of appropriate technology options, which enables the aggregation and disaggregation of energy systems by defining functionals for single technologies, packages integrating multi-technologies, and mini-systems such as regions implementing industrial symbiosis. Based on the model, the combinations of technologies on both energy supply and demand sides can be addressed considering not only the societal scenarios such as resource prices, economic growth and population change but also the technical scenarios including the development and penetration of energy-related technologies such as distributed solid oxide fuel cells in residential sectors and new-generation vehicles, and the replacement and shift of current technologies such as heat pumps for air conditioning and centralized power generation. The developed model consists of two main modules; namely, a power generation dispatching module for the

  3. The role of subcutaneous tissue stiffness on microneedle performance in a representative in vitro model of skin.

    Science.gov (United States)

    Moronkeji, K; Todd, S; Dawidowska, I; Barrett, S D; Akhtar, R

    2017-11-10

    There has been growing interest in the mechanical behaviour of skin due to the rapid development of microneedle devices for drug delivery applications into skin. However, most in vitro experimentation studies that are used to evaluate microneedle performance do not consider the biomechanical properties of skin or that of the subcutaneous layers. In this study, a representative experimental model of skin was developed which was comprised of subcutaneous and muscle mimics. Neonatal porcine skin from the abdominal and back regions was used, with gelatine gels of differing water content (67, 80, 88 and 96%) to represent the subcutaneous tissue, and a type of ballistic gelatine, Perma-Gel®, as a muscle mimic. Dynamic nanoindentation was used to characterize the mechanical properties of each of these layers. A custom-developed impact test rig was used to apply dense polymethylmethacrylate (PMMA) microneedles to the skin models in a controlled and repeatable way with quantification of the insertion force and velocity. Image analysis methods were used to measure penetration depth and area of the breach caused by microneedle penetration following staining and optical imaging. The nanoindentation tests demonstrated that the tissue mimics matched expected values for subcutaneous and muscle tissue, and that the compliance of the subcutaneous mimics increased linearly with water content. The abdominal skin was thinner and less stiff as compared to back skin. The maximum force decreased with gel water content in the abdominal skin but not in the back skin. Overall, larger and deeper perforations were found in the skin models with increasing water content. These data demonstrate the importance of subcutaneous tissue on microneedle performance and the need for representative skin models in microneedle technology development. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  4. Representing Microbial Dormancy in Soil Decomposition Models Improves Model Performance and Reveals Key Ecosystem Controls on Microbial Activity

    Science.gov (United States)

    He, Y.; Yang, J.; Zhuang, Q.; Wang, G.; Liu, Y.

    2014-12-01

    Climate feedbacks from soils can result from environmental change and subsequent responses of plant and microbial communities and nutrient cycling. Explicit consideration of microbial life history traits and strategy may be necessary to predict climate feedbacks due to microbial physiology and community changes and their associated effect on carbon cycling. In this study, we developed an explicit microbial-enzyme decomposition model and examined model performance with and without representation of dormancy at six temperate forest sites with observed soil efflux ranged from 4 to 10 years across different forest types. We then extrapolated the model to all temperate forests in the Northern Hemisphere (25-50°N) to investigate spatial controls on microbial and soil C dynamics. Both models captured the observed soil heterotrophic respiration (RH), yet no-dormancy model consistently exhibited large seasonal amplitude and overestimation in microbial biomass. Spatially, the total RH from temperate forests based on dormancy model amounts to 6.88PgC/yr, and 7.99PgC/yr based on no-dormancy model. However, no-dormancy model notably overestimated the ratio of microbial biomass to SOC. Spatial correlation analysis revealed key controls of soil C:N ratio on the active proportion of microbial biomass, whereas local dormancy is primarily controlled by soil moisture and temperature, indicating scale-dependent environmental and biotic controls on microbial and SOC dynamics. These developments should provide essential support to modeling future soil carbon dynamics and enhance the avenue for collaboration between empirical soil experiment and modeling in the sense that more microbial physiological measurements are needed to better constrain and evaluate the models.

  5. Application of morphological and physiological parameters representative of a Brazilian population sample in the respiratory tract model

    International Nuclear Information System (INIS)

    Dos Reis, A. A.; Cardoso, J. C. S.; Lourenco, M. C.

    2007-01-01

    The human respiratory tract model (HRTM) adopted by ICRP in its Publication 66 accounts for the morphology and physiology of the respiratory tract. The characteristics of air drawn into the lungs and exhaled are greatly influenced by the morphology of the respiratory tract, which causes numerous changes in pressure, flow rate, direction and humidity as air moves into and out of the lungs. These characteristics are important to determine the fractional deposition. It is known that the morphology and physiology are influenced by environmental, occupational and economic conditions. The ICRP recommends, for a reliable evaluation of the regional deposition, the use of parameters from a local population wherever such information is available. The main purpose of this study is to verify the influence of using the morphology and physiology parameters representative of a sample of the Brazilian population on the deposition model of the ICRP Publication 66 model. (authors)

  6. Clinical Prediction Models for Cardiovascular Disease: Tufts Predictive Analytics and Comparative Effectiveness Clinical Prediction Model Database.

    Science.gov (United States)

    Wessler, Benjamin S; Lai Yh, Lana; Kramer, Whitney; Cangelosi, Michael; Raman, Gowri; Lutz, Jennifer S; Kent, David M

    2015-07-01

    Clinical prediction models (CPMs) estimate the probability of clinical outcomes and hold the potential to improve decision making and individualize care. For patients with cardiovascular disease, there are numerous CPMs available although the extent of this literature is not well described. We conducted a systematic review for articles containing CPMs for cardiovascular disease published between January 1990 and May 2012. Cardiovascular disease includes coronary heart disease, heart failure, arrhythmias, stroke, venous thromboembolism, and peripheral vascular disease. We created a novel database and characterized CPMs based on the stage of development, population under study, performance, covariates, and predicted outcomes. There are 796 models included in this database. The number of CPMs published each year is increasing steadily over time. Seven hundred seventeen (90%) are de novo CPMs, 21 (3%) are CPM recalibrations, and 58 (7%) are CPM adaptations. This database contains CPMs for 31 index conditions, including 215 CPMs for patients with coronary artery disease, 168 CPMs for population samples, and 79 models for patients with heart failure. There are 77 distinct index/outcome pairings. Of the de novo models in this database, 450 (63%) report a c-statistic and 259 (36%) report some information on calibration. There is an abundance of CPMs available for a wide assortment of cardiovascular disease conditions, with substantial redundancy in the literature. The comparative performance of these models, the consistency of effects and risk estimates across models and the actual and potential clinical impact of this body of literature is poorly understood. © 2015 American Heart Association, Inc.

  7. Pharmacodynamic modelling of in vitro activity of tetracycline against a representative, naturally occurring population of porcine Escherichia coli

    DEFF Research Database (Denmark)

    Ahmad, Amais; Zachariasen, Camilla; Christiansen, Lasse Engbo

    2015-01-01

    of Escherichia coli representative of those found in the Danish pig population, we compared the growth of 50 randomly selected strains. The observed net growth rates were used to describe the in vitro pharmacodynamic relationship between drug concentration and net growth rate based on E max model with three...... concentrations, and this decline was greater in susceptible strains than resistant strains. The lag phase, defined as the time needed for the strain to reach an OD600 value of 0.01, increased exponentially with increasing tetracycline concentration. The pharmacodynamic parameters confirmed that the [Formula: see...

  8. Dynamic viscosity modeling of methane plus n-decane and methane plus toluene mixtures: Comparative study of some representative models

    DEFF Research Database (Denmark)

    Baylaucq, A.; Boned, C.; Canet, X.

    2005-01-01

    Viscosity measurements of well-defined mixtures are useful in order to evaluate existing viscosity models. Recently, an extensive experimental study of the viscosity at pressures up to 140 MPa has been carried out for the binary systems methane + n-decane and methane toluene, between 293.15 and 3...

  9. NewsPaperBox - Online News Space: a visual model for representing the social space of a website

    Directory of Open Access Journals (Sweden)

    Selçuk Artut

    2010-02-01

    Full Text Available NewsPaperBox * propounds an alternative visual model utilizing the treemap algorithm to represent the collective use of a website that evolves in response to user interaction. While the technology currently exists to track various user behaviors such as number of clicks, duration of stay on a given web site, these statistics are not yet employed to influence the visual representation of that site's design in real time. In that sense, this project propounds an alternative modeling of a representational outlook of a website that is developed by collaborations and competitions of its global users. This paper proposes the experience of cyberspace as a generative process driven by its effective user participation.

  10. 3D Models of Female Pelvis Structures Reconstructed and Represented in Combination with Anatomical and Radiological Sections.

    Science.gov (United States)

    Asensio Romero, L; Asensio Gómez, M; Prats-Galino, A; Juanes Méndez, J A

    2018-01-15

    We present a computer program designed to visualize and interact with three-dimensional models of the main anatomical structures of the female pelvis. They are reconstructed from serial sections of corpse, from the Visible Human project of the Medical Library of the United States and from serial sections of high-resolution magnetic resonance. It is possible to represent these three-dimensional structures in any spatial orientation, together with sectional images of corpse and magnetic resonance imaging, in the three planes of space (axial, coronal and sagittal) that facilitates the anatomical understanding and the identification of the set of visceral structures of this body region. Actually, there are few studies that analysze in detail the radiological anatomy of the female pelvis using three-dimensional models together with sectional images, making use of open applications for the representation of virtual scenes on low cost Windows® platforms. Our technological development allows the observation of the main female pelvis viscera in three dimensions with a very intuitive graphic interface. This computer application represents an important training tool for both medical students and specialists in gynecology and as a preliminary step in the planning of pelvic floor surgery.

  11. Peer Review of Clinical Information Models: A Web 2.0 Crowdsourced Approach.

    Science.gov (United States)

    Leslie, Heather; Ljosland Bakke, Silje

    2017-01-01

    Over the past 8 years the openEHR Clinical Model program has been developing a Web 2.0 approach and tooling to support the development, review and governance of atomic clincial information models, known as archetypes. This paper describes the background and review process, and provides a practical example where cross standards organisation collaboration resulted in jointly agreed clinical content which was subsequently represented in different implementation formalisms that were effectively semantically aligned. The discussion and conclusions highlight some of the socio-technical benefits and challenges facing organisations who seek to govern automic clinical information models in a global and collaborative online community.

  12. Clinical psychology of religion. A training model

    NARCIS (Netherlands)

    Uden, M.H.F. van; Pieper, J.Z.T.

    2003-01-01

    In this paper we will show you a part of a course "Clinical Psychology of Religion" that has been developed in the Netherlands for introducing mental health professionals in the field of clinical psychology of religion. Clinical psychology of religion applies insights from general psychology of

  13. Assessment of Climate Change Impacts on Water Resources in Three Representative Ukrainian Catchments Using Eco-Hydrological Modelling

    Directory of Open Access Journals (Sweden)

    Iulii Didovets

    2017-03-01

    Full Text Available The information about climate change impact on river discharge is vitally important for planning adaptation measures. The future changes can affect different water-related sectors. The main goal of this study was to investigate the potential water resource changes in Ukraine, focusing on three mesoscale river catchments (Teteriv, Upper Western Bug, and Samara characteristic for different geographical zones. The catchment scale watershed model—Soil and Water Integrated Model (SWIM—was setup, calibrated, and validated for the three catchments under consideration. A set of seven GCM-RCM (General Circulation Model-Regional Climate Model coupled climate scenarios corresponding to RCPs (Representative Concentration Pathways 4.5 and 8.5 were used to drive the hydrological catchment model. The climate projections, used in the study, were considered as three combinations of low, intermediate, and high end scenarios. Our results indicate the shifts in the seasonal distribution of runoff in all three catchments. The spring high flow occurs earlier as a result of temperature increases and earlier snowmelt. The fairly robust trend is an increase in river discharge in the winter season, and most of the scenarios show a potential decrease in river discharge in the spring.

  14. The Bobath concept - a model to illustrate clinical practice.

    Science.gov (United States)

    Michielsen, Marc; Vaughan-Graham, Julie; Holland, Ann; Magri, Alba; Suzuki, Mitsuo

    2017-12-17

    The model of Bobath clinical practice provides a framework identifying the unique aspects of the Bobath concept in terms of contemporary neurological rehabilitation. The utilisation of a framework to illustrate the clinical application of the Bobath concept provides the basis for a common understanding with respect to Bobath clinical practice, education, and research. The development process culminating in the model of Bobath clinical practice is described. The use of the model in clinical practice is illustrated using two cases: a client with a chronic incomplete spinal cord injury and a client with a stroke. This article describes the clinical application of the Bobath concept in terms of the integration of posture and movement with respect to the quality of task performance, applying the Model of Bobath Clinical Practice. Facilitation, a key aspect of Bobath clinical practice, was utilised to positively affect motor control and perception in two clients with impairment-related movement problems due to neurological pathology and associated activity limitations and participation restrictions - the outcome measures used to reflect the individual clinical presentation. Implications for Rehabilitation The model of Bobath clinical practice provides a framework identifying the unique aspects of the Bobath-concept. The model of Bobath clinical practice provides the basis for a common understanding with respect to Bobath clinical practice, education, and research. The clinical application of the Bobath-concept highlights the integration of posture and movement with respect to the quality of task performance. Facilitation, a key aspect of Bobath clinical practice, positively affects motor control, and perception.

  15. Design and Fabrication of DebriSat - A Representative LEO Satellite for Improvements to Standard Satellite Breakup Models

    Science.gov (United States)

    Clark, S.; Dietrich, A.; Fitz-Coy, N.; Weremeyer, M.; Liou, J.-C.

    2012-01-01

    This paper discusses the design and fabrication of DebriSat, a 50 kg satellite developed to be representative of a modern low Earth orbit satellite in terms of its components, materials used, and fabrication procedures. DebriSat will be the target of a future hypervelocity impact experiment to determine the physical characteristics of debris generated after an on-orbit collision of a modern LEO satellite. The major ground-based satellite impact experiment used by DoD and NASA in their development of satellite breakup models was SOCIT, conducted in 1992. The target used for that experiment was a Navy transit satellite (40 cm, 35 kg) fabricated in the 1960's. Modern satellites are very different in materials and construction techniques than those built 40 years ago. Therefore, there is a need to conduct a similar experiment using a modern target satellite to improve the fidelity of the satellite breakup models. To ensure that DebriSat is truly representative of typical LEO missions, a comprehensive study of historical LEO satellite designs and missions within the past 15 years for satellites ranging from 1 kg to 5000 kg was conducted. This study identified modern trends in hardware, material, and construction practices utilized in recent LEO missions. Although DebriSat is an engineering model, specific attention is placed on the quality, type, and quantity of the materials used in its fabrication to ensure the integrity of the outcome. With the exception of software, all other aspects of the satellite s design, fabrication, and assembly integration and testing will be as rigorous as that of an actual flight vehicle. For example, to simulate survivability of launch loads, DebriSat will be subjected to a vibration test. As well, the satellite will undergo thermal vacuum tests to verify that the components and overall systems meet typical environmental standards. Proper assembly and integration techniques will involve comprehensive joint analysis, including the precise

  16. Analysis of the Spatial Variation of Network-Constrained Phenomena Represented by a Link Attribute Using a Hierarchical Bayesian Model

    Directory of Open Access Journals (Sweden)

    Zhensheng Wang

    2017-02-01

    Full Text Available The spatial variation of geographical phenomena is a classical problem in spatial data analysis and can provide insight into underlying processes. Traditional exploratory methods mostly depend on the planar distance assumption, but many spatial phenomena are constrained to a subset of Euclidean space. In this study, we apply a method based on a hierarchical Bayesian model to analyse the spatial variation of network-constrained phenomena represented by a link attribute in conjunction with two experiments based on a simplified hypothetical network and a complex road network in Shenzhen that includes 4212 urban facility points of interest (POIs for leisure activities. Then, the methods named local indicators of network-constrained clusters (LINCS are applied to explore local spatial patterns in the given network space. The proposed method is designed for phenomena that are represented by attribute values of network links and is capable of removing part of random variability resulting from small-sample estimation. The effects of spatial dependence and the base distribution are also considered in the proposed method, which could be applied in the fields of urban planning and safety research.

  17. Explaining clinical behaviors using multiple theoretical models

    Directory of Open Access Journals (Sweden)

    Eccles Martin P

    2012-10-01

    Full Text Available Abstract Background In the field of implementation research, there is an increased interest in use of theory when designing implementation research studies involving behavior change. In 2003, we initiated a series of five studies to establish a scientific rationale for interventions to translate research findings into clinical practice by exploring the performance of a number of different, commonly used, overlapping behavioral theories and models. We reflect on the strengths and weaknesses of the methods, the performance of the theories, and consider where these methods sit alongside the range of methods for studying healthcare professional behavior change. Methods These were five studies of the theory-based cognitions and clinical behaviors (taking dental radiographs, performing dental restorations, placing fissure sealants, managing upper respiratory tract infections without prescribing antibiotics, managing low back pain without ordering lumbar spine x-rays of random samples of primary care dentists and physicians. Measures were derived for the explanatory theoretical constructs in the Theory of Planned Behavior (TPB, Social Cognitive Theory (SCT, and Illness Representations specified by the Common Sense Self Regulation Model (CSSRM. We constructed self-report measures of two constructs from Learning Theory (LT, a measure of Implementation Intentions (II, and the Precaution Adoption Process. We collected data on theory-based cognitions (explanatory measures and two interim outcome measures (stated behavioral intention and simulated behavior by postal questionnaire survey during the 12-month period to which objective measures of behavior (collected from routine administrative sources were related. Planned analyses explored the predictive value of theories in explaining variance in intention, behavioral simulation and behavior. Results Response rates across the five surveys ranged from 21% to 48%; we achieved the target sample size for three of

  18. Explaining clinical behaviors using multiple theoretical models.

    Science.gov (United States)

    Eccles, Martin P; Grimshaw, Jeremy M; MacLennan, Graeme; Bonetti, Debbie; Glidewell, Liz; Pitts, Nigel B; Steen, Nick; Thomas, Ruth; Walker, Anne; Johnston, Marie

    2012-10-17

    In the field of implementation research, there is an increased interest in use of theory when designing implementation research studies involving behavior change. In 2003, we initiated a series of five studies to establish a scientific rationale for interventions to translate research findings into clinical practice by exploring the performance of a number of different, commonly used, overlapping behavioral theories and models. We reflect on the strengths and weaknesses of the methods, the performance of the theories, and consider where these methods sit alongside the range of methods for studying healthcare professional behavior change. These were five studies of the theory-based cognitions and clinical behaviors (taking dental radiographs, performing dental restorations, placing fissure sealants, managing upper respiratory tract infections without prescribing antibiotics, managing low back pain without ordering lumbar spine x-rays) of random samples of primary care dentists and physicians. Measures were derived for the explanatory theoretical constructs in the Theory of Planned Behavior (TPB), Social Cognitive Theory (SCT), and Illness Representations specified by the Common Sense Self Regulation Model (CSSRM). We constructed self-report measures of two constructs from Learning Theory (LT), a measure of Implementation Intentions (II), and the Precaution Adoption Process. We collected data on theory-based cognitions (explanatory measures) and two interim outcome measures (stated behavioral intention and simulated behavior) by postal questionnaire survey during the 12-month period to which objective measures of behavior (collected from routine administrative sources) were related. Planned analyses explored the predictive value of theories in explaining variance in intention, behavioral simulation and behavior. Response rates across the five surveys ranged from 21% to 48%; we achieved the target sample size for three of the five surveys. For the predictor variables

  19. Development of a clinical decision model for thyroid nodules

    Directory of Open Access Journals (Sweden)

    Eberhardt John

    2009-08-01

    Full Text Available Abstract Background Thyroid nodules represent a common problem brought to medical attention. Four to seven percent of the United States adult population (10–18 million people has a palpable thyroid nodule, however the majority (>95% of thyroid nodules are benign. While, fine needle aspiration remains the most cost effective and accurate diagnostic tool for thyroid nodules in current practice, over 20% of patients undergoing FNA of a thyroid nodule have indeterminate cytology (follicular neoplasm with associated malignancy risk prevalence of 20–30%. These patients require thyroid lobectomy/isthmusectomy purely for the purpose of attaining a definitive diagnosis. Given that the majority (70–80% of these patients have benign surgical pathology, thyroidectomy in these patients is conducted principally with diagnostic intent. Clinical models predictive of malignancy risk are needed to support treatment decisions in patients with thyroid nodules in order to reduce morbidity associated with unnecessary diagnostic surgery. Methods Data were analyzed from a completed prospective cohort trial conducted over a 4-year period involving 216 patients with thyroid nodules undergoing ultrasound (US, electrical impedance scanning (EIS and fine needle aspiration cytology (FNA prior to thyroidectomy. A Bayesian model was designed to predict malignancy in thyroid nodules based on multivariate dependence relationships between independent covariates. Ten-fold cross-validation was performed to estimate classifier error wherein the data set was randomized into ten separate and unique train and test sets consisting of a training set (90% of records and a test set (10% of records. A receiver-operating-characteristics (ROC curve of these predictions and area under the curve (AUC were calculated to determine model robustness for predicting malignancy in thyroid nodules. Results Thyroid nodule size, FNA cytology, US and EIS characteristics were highly predictive of

  20. Dynamic neuronal ensembles: Issues in representing structure change in object-oriented, biologically-based brain models

    Energy Technology Data Exchange (ETDEWEB)

    Vahie, S.; Zeigler, B.P.; Cho, H. [Univ. of Arizona, Tucson, AZ (United States)

    1996-12-31

    This paper describes the structure of dynamic neuronal ensembles (DNEs). DNEs represent a new paradigm for learning, based on biological neural networks that use variable structures. We present a computational neural element that demonstrates biological neuron functionality such as neurotransmitter feedback absolute refractory period and multiple output potentials. More specifically, we will develop a network of neural elements that have the ability to dynamically strengthen, weaken, add and remove interconnections. We demonstrate that the DNE is capable of performing dynamic modifications to neuron connections and exhibiting biological neuron functionality. In addition to its applications for learning, DNEs provide an excellent environment for testing and analysis of biological neural systems. An example of habituation and hyper-sensitization in biological systems, using a neural circuit from a snail is presented and discussed. This paper provides an insight into the DNE paradigm using models developed and simulated in DEVS.

  1. Representing a Model Using Data Mining Approach for Maximizing Profit with Considering Product Assortment and Space Allocation Decisions

    Directory of Open Access Journals (Sweden)

    Manoochehr Ansari

    2016-12-01

    Full Text Available The choice of which products to stock among numerous competing products and how much space to allocate to those products are central decisions for retailers. This study aimed to apply data mining approach so that, we got needed information from large datasets of sale transactions to find the relations between products and to make product assortments. Thus, we represented a model for product assortment and space allocation. Research population was transactional data of a store, the sample included transactional data of one-month period in the time series. Data were collected in October and November, 2015 from Shaghayegh store. 525 transactions with regard to 79 different products were analyzed. Based on the result 10 product assortments formed although some products were allocated to more than 1 product category. By solving profit equation and finding volume increase indices we allocated spaces for each product assortment.

  2. Modeling Fluid’s Dynamics with Master Equations in Ultrametric Spaces Representing the Treelike Structure of Capillary Networks

    Directory of Open Access Journals (Sweden)

    Andrei Khrennikov

    2016-07-01

    Full Text Available We present a new conceptual approach for modeling of fluid flows in random porous media based on explicit exploration of the treelike geometry of complex capillary networks. Such patterns can be represented mathematically as ultrametric spaces and the dynamics of fluids by ultrametric diffusion. The images of p-adic fields, extracted from the real multiscale rock samples and from some reference images, are depicted. In this model the porous background is treated as the environment contributing to the coefficients of evolutionary equations. For the simplest trees, these equations are essentially less complicated than those with fractional differential operators which are commonly applied in geological studies looking for some fractional analogs to conventional Euclidean space but with anomalous scaling and diffusion properties. It is possible to solve the former equation analytically and, in particular, to find stationary solutions. The main aim of this paper is to attract the attention of researchers working on modeling of geological processes to the novel utrametric approach and to show some examples from the petroleum reservoir static and dynamic characterization, able to integrate the p-adic approach with multifractals, thermodynamics and scaling. We also present a non-mathematician friendly review of trees and ultrametric spaces and pseudo-differential operators on such spaces.

  3. Application of morphological and physiological parameters representative of a sample Brazilian population in the human respiratory tract model

    International Nuclear Information System (INIS)

    Reis, A.A.; Cardoso, J.C.S.; Lourenco, M.C.

    2005-01-01

    Full text: The Human Respiratory Tract Model (HRTM) proposed in ICRP Publication 66 account for the morphology and physiology of the respiratory tract. The characteristics of air drawn into the lungs and exhaled are greatly influenced by the morphology of the respiratory tract, which causes numerous changes in pressure, flow rate, direction and humidity as air moves into and out of the lungs. These changing characteristics can influence the rates and the sites of deposition. Concerning the respiratory physiological parameters the breathing characteristics influence the volume, the inhalation rate of air and the portion that enters through the nose and the mouth. These characteristics are important to determine the fractional deposition. The HRTM model uses morphological and physiological parameters from the Caucasian man to establish deposition fractions in the respiratory tract regions. lt is known that the morphology and physiology are influenced by environmental, occupational and economic conditions. The ICRP recommends for a reliable evaluation of the regional deposition the use of parameters from a local population when information is available. The main purpose of this study is to verify the influence in using the morphology and physiology parameters representative of a sample of the Brazilian population on the deposition model of ICRP Publication 66. The morphological and physiological data were obtained from the literature. The software EXCEL for Windows (version 2000) was used in order to implement the deposition model and also to allow the changes in parameters of interest. Initially, the implemented model was checked using the parameters defined in ICRP and the results of the fraction deposition in the respiratory tract compartments were compared. Finally, morphological and physiological parameters from Brazilian adult male were applied and the fractional deposition calculated. The respiratory values at different levels of activity for ages varying from

  4. Experimental study and modelling of the well-mixing length. Application to the representativeness of sampling points in duct

    International Nuclear Information System (INIS)

    Alengry, Jonathan

    2014-01-01

    Monitoring of gaseous releases from nuclear installations in the environment and air cleaning efficiency measurement are based on regular measurements of concentrations of contaminants in outlet chimneys and ventilation systems. The concentration distribution may be heterogeneous at the measuring point if the distance setting of the mixing is not sufficient. The question is about the set up of the measuring point in duct and the error compared to the homogeneous concentration in case of non-compliance with this distance. This study defines the so-called 'well mixing length' from laboratory experiments. The bench designed for these tests allowed to reproduce flows in long circular and rectangular ducts, each including a bend. An optical measurement technique has been developed, calibrated and used to measure the concentration distribution of a tracer injected in the flow. The experimental results in cylindrical duct have validated an analytical model based on the convection-diffusion equation of a tracer, and allowed to propose models of good mixing length and representativeness of sampling points. In rectangular duct, the acquired measures constitute a first database on the evolution of the homogenization of a tracer, in the perspective of numerical simulations exploring more realistic conditions for measurements in situ. (author) [fr

  5. An improved ENSO simulation by representing chlorophyll-induced climate feedback in the NCAR Community Earth System Model.

    Science.gov (United States)

    Kang, Xianbiao; Zhang, Rong-Hua; Gao, Chuan; Zhu, Jieshun

    2017-12-07

    The El Niño-Southern oscillation (ENSO) simulated in the Community Earth System Model of the National Center for Atmospheric Research (NCAR CESM) is much stronger than in reality. Here, satellite data are used to derive a statistical relationship between interannual variations in oceanic chlorophyll (CHL) and sea surface temperature (SST), which is then incorporated into the CESM to represent oceanic chlorophyll -induced climate feedback in the tropical Pacific. Numerical runs with and without the feedback (referred to as feedback and non-feedback runs) are performed and compared with each other. The ENSO amplitude simulated in the feedback run is more accurate than that in the non-feedback run; quantitatively, the Niño3 SST index is reduced by 35% when the feedback is included. The underlying processes are analyzed and the results show that interannual CHL anomalies exert a systematic modulating effect on the solar radiation penetrating into the subsurface layers, which induces differential heating in the upper ocean that affects vertical mixing and thus SST. The statistical modeling approach proposed in this work offers an effective and economical way for improving climate simulations.

  6. Why do global climate models struggle to represent low-level clouds in the West African summer monsoon?

    Science.gov (United States)

    Knippertz, Peter; Hannak, Lisa; Fink, Andreas H.; Kniffka, Anke; Pante, Gregor

    2017-04-01

    Climate models struggle to realistically represent the West African monsoon (WAM), which hinders reliable future projections and the development of adequate adaption measures. Low-level clouds over southern West Africa (5-10°N, 8°W-8°E) during July-September are an integral part of the WAM through their effect on the surface energy balance and precipitation, but their representation in climate models has so far received little attention. These clouds usually form during the night near the level of the nocturnal low-level jet ( 950 hPa), thicken and spread until the mid-morning ( 09 UTC), and then break up and rise in the course of the day, typically to about 850 hPa. The low thermal contrast to the surface and the frequent presence of obscuring higher-level clouds make detection of the low-level clouds from space rather challenging. Here we use 30 years of output from 18 models participating in the Coupled Model Intercomparison Project Phase 5 (CMIP5) as well as 20 years of output from 8 models participating in the Year of Tropical Convection (YoTC) experiments to identify cloud biases and their causes. A great advantage of the YoTC dataset is the 6-hourly output frequency, which allows an analysis of the diurnal cycle, and the availability of temperature and moisture tendencies from parameterized processes such as convection, radiation and boundary-layer turbulence. A comparison to earlier analyses based on CMIP3 output reveals rather limited improvements with regard to the represenation of low-level cloud and winds. Compared to ERA-Interim re-analyses, which shows satisfactory agreement with surface observations, many of the CMIP5 and YoTC models still have large biases in low-level cloudiness of both signs and a tendency to too high elevation and too weak diurnal cycles. At the same time, these models tend to have too strong low-level jets, the impact of which is unclear due to concomitant effects on temperature and moisture advection as well as turbulent

  7. Standardized training in nurse model travel clinics.

    Science.gov (United States)

    Sofarelli, Theresa A; Ricks, Jane H; Anand, Rahul; Hale, Devon C

    2011-01-01

    International travel plays a significant role in the emergence and redistribution of major human diseases. The importance of travel medicine clinics for preventing morbidity and mortality has been increasingly appreciated, although few studies have thus far examined the management and staff training strategies that result in successful travel-clinic operations. Here, we describe an example of travel-clinic operation and management coordinated through the University of Utah School of Medicine, Division of Infectious Diseases. This program, which involves eight separate clinics distributed statewide, functions both to provide patient consult and care services, as well as medical provider training and continuing medical education (CME). Initial training, the use of standardized forms and protocols, routine chart reviews and monthly continuing education meetings are the distinguishing attributes of this program. An Infectious Disease team consisting of one medical doctor (MD) and a physician assistant (PA) act as consultants to travel nurses who comprise the majority of clinic staff. Eight clinics distributed throughout the state of Utah serve approximately 6,000 travelers a year. Pre-travel medical services are provided by 11 nurses, including 10 registered nurses (RNs) and 1 licensed practical nurse (LPN). This trained nursing staff receives continuing travel medical education and participate in the training of new providers. All nurses have completed a full training program and 7 of the 11 (64%) of clinic nursing staff serve more than 10 patients a week. Quality assurance measures show that approximately 0.5% of charts reviewed contain a vaccine or prescription error which require patient notification for correction. Using an initial training program, standardized patient intake forms, vaccine and prescription protocols, preprinted prescriptions, and regular CME, highly trained nurses at travel clinics are able to provide standardized pre-travel care to

  8. The cost of clinical mastitis in the first 30 days of lactation: An economic modeling tool.

    Science.gov (United States)

    Rollin, E; Dhuyvetter, K C; Overton, M W

    2015-12-01

    Clinical mastitis results in considerable economic losses for dairy producers and is most commonly diagnosed in early lactation. The objective of this research was to estimate the economic impact of clinical mastitis occurring during the first 30 days of lactation for a representative US dairy. A deterministic partial budget model was created to estimate direct and indirect costs per case of clinical mastitis occurring during the first 30 days of lactation. Model inputs were selected from the available literature, or when none were available, from herd data. The average case of clinical mastitis resulted in a total economic cost of $444, including $128 in direct costs and $316 in indirect costs. Direct costs included diagnostics ($10), therapeutics ($36), non-saleable milk ($25), veterinary service ($4), labor ($21), and death loss ($32). Indirect costs included future milk production loss ($125), premature culling and replacement loss ($182), and future reproductive loss ($9). Accurate decision making regarding mastitis control relies on understanding the economic impacts of clinical mastitis, especially the longer term indirect costs that represent 71% of the total cost per case of mastitis. Future milk production loss represents 28% of total cost, and future culling and replacement loss represents 41% of the total cost of a case of clinical mastitis. In contrast to older estimates, these values represent the current dairy economic climate, including milk price ($0.461/kg), feed price ($0.279/kg DM (dry matter)), and replacement costs ($2,094/head), along with the latest published estimates on the production and culling effects of clinical mastitis. This economic model is designed to be customized for specific dairy producers and their herd characteristics to better aid them in developing mastitis control strategies. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  9. Source apportionment of population representative samples of PM(2.5) in three European cities using structural equation modelling.

    Science.gov (United States)

    Ilacqua, Vito; Hänninen, Otto; Saarela, Kristina; Katsouyanni, Klea; Künzli, Nino; Jantunen, Matti

    2007-10-01

    Apportionment of urban particulate matter (PM) to sources is central for air quality management and efficient reduction of the substantial public health risks associated with fine particles (PM(2.5)). Traffic is an important source combustion particles, but also a significant source of resuspended particles that chemically resemble Earth's crust and that are not affected by development of cleaner motor technologies. A substantial fraction of urban ambient PM originates from long-range transport outside the immediate urban environment including secondary particles formed from gaseous emissions of mainly sulphur, nitrogen oxides and ammonia. Most source apportionment studies are based on small number of fixed monitoring sites and capture well population exposures to regional and long-range transported particles. However, concentrations from local sources are very unevenly distributed and the results from such studies are therefore poorly representative of the actual exposures. The current study uses PM(2.5) data observed at population based random sampled residential locations in Athens, Basle and Helsinki with 17 elemental constituents, selected VOCs (xylenes, trimethylbenzenes, nonane and benzene) and light absorbance (black smoke). The major sources identified across the three cities included crustal, salt, long-range transported inorganic and traffic sources. Traffic was associated separately with source categories with crustal (especially Athens and Helsinki) and long-range transported chemical composition (all cities). Remarkably high fractions of the variability of elemental (R(2)>0.6 except for Ca in Basle 0.38) and chemical concentrations (R(2)>0.5 except benzene in Basle 0.22 and nonane in Athens 0.39) are explained by the source factors of an SEM model. The RAINS model that is currently used as the main tool in developing European air quality management policies seems to capture the local urban fraction (the city delta term) quite well, but underestimates

  10. The Three Estates Model: Represented and Satirised in Chaucer’s General Prologue to the Canterbury Tales

    Directory of Open Access Journals (Sweden)

    Sadenur Doğan

    2013-07-01

    Full Text Available This paper presents an investigation of the ‘Three Estates Model’ of the English medieval society in Chaucer’s General Prologue to the Canterbury Tales. Based upon the descriptions and illustrations of the characters, it aims to explore the hierarchal structure of the medieval society which is divided into three main groups or ‘estates’: the ones who pray, the ones who rule and govern, and the ones who work. In the General Prologue, Chaucer gives a series of sketches of the characters that are the representatives of the three estates, and through these depictions he investigates the social characteristics and roles of the medieval people who are expected to speak and behave in accordance with what their social group requires. While presenting Three Estates Model, he employs the tradition of ‘estates satire’ by criticising the social vices resulting from the corruption in this model. Through the characteristics and virtues of the ‘Knight’, the ‘Parson’, and the ‘Plowman’, he demonstrates the perfect integration of the people who belong to chivalry, clergy and the commoners in the medieval English society. Also, by offering contrasting views to these positive traits in the portrayal of almost all of the other characters, as illustrated in the portrayal of the ‘Monk’, the ‘Reeve’, and the ‘Wife of Bathe’ in this paper, he criticises the vices and sins (that are mainly resulted from the religious, financial and moral corruption of the people belonging to the social classes of the Middle Ages.

  11. Applicability of the Linear Sorption Isotherm Model to Represent Contaminant Transport Processes in Site Wide Performance Assessments

    International Nuclear Information System (INIS)

    FOGWELL, T.W.; LAST, G.V.

    2003-01-01

    The estimation of flux of contaminants through the vadose zone to the groundwater under varying geologic, hydrologic, and chemical conditions is key to making technically credible and sound decisions regarding soil site characterization and remediation, single-shell tank retrieval, and waste site closures (DOE 2000). One of the principal needs identified in the science and technology roadmap (DOE 2000) is the need to improve the conceptual and numerical models that describe the location of contaminants today, and to provide the basis for forecasting future movement of contaminants on both site-specific and site-wide scales. The State of Knowledge (DOE 1999) and Preliminary Concepts documents describe the importance of geochemical processes on the transport of contaminants through the Vadose Zone. These processes have been identified in the international list of Features, Events, and Processes (FEPs) (NEA 2000) and included in the list of FEPS currently being developed for Hanford Site assessments (Soler et al. 2001). The current vision for Hanford site-wide cumulative risk assessments as performed using the System Assessment Capability (SAC) is to represent contaminant adsorption using the linear isotherm (empirical distribution coefficient, K d ) sorption model. Integration Project Expert Panel (PEP) comments indicate that work is required to adequately justify the applicability of the linear sorption model, and to identify and defend the range of K d values that are adopted for assessments. The work plans developed for the Science and Technology (S and T) efforts, SAC, and the Core Projects must answer directly the question of ''Is there a scientific basis for the application of the linear sorption isotherm model to the complex wastes of the Hanford Site?'' This paper is intended to address these issues. The reason that well documented justification is required for using the linear sorption (K d ) model is that this approach is strictly empirical and is often

  12. A clinical intranet model for radiation oncology

    International Nuclear Information System (INIS)

    Brooks, Ken; Fox, Tim; Davis, Larry

    1997-01-01

    Purpose: A new paradigm in computing is being formulated from advances in client-server technology. This new way of accessing data in a network is referred to variously as Web-based computing, Internet computing, or Intranet computing. The difference between an internet and intranet being that the former is for global access and the later is only for intra-departmental access. Our purpose with this work is to develop a clinically useful radiation oncology intranet for accessing physically disparate data sources. Materials and Methods: We have developed an intranet client-server system using Windows-NT Server 4.0 running Internet Information Server (IIS) on the back-end and client PCs using a typical World Wide Web (WWW) browser. The clients also take advantage of the Microsoft Open Database Connectivity (ODBC) standard for accessing commercial database systems. The various data sources used include: a traditional Radiation Oncology Information (ROIS) System (VARiS 1.3 tm ); a 3-D treatment planning system (CAD Plan tm ); a beam scanning system (Wellhoffer tm ); as well as an electronic portal imaging device (PortalVision tm ) and a CT-Simulator providing digitally reconstructed radiographs (DRRs) (Picker AcQsim tm ). We were able to leverage previously developed Microsoft Visual C++ applications without major re-writing of source code for this. Results: With the data sources and development materials used, we were able to develop a series of WWW-based clinical tool kits. The tool kits were designed to provide profession-specific clinical information. The physician's tool kit provides a treatment schedule for daily patients along with a dose summary from VARiS and the ability to review portal images and prescription images from the EPID and Picker. The physicists tool kit compares dose summaries from VARiS with an independent check against RTP beam data and serves as a quick 'chart-checker'. Finally, an administrator tool kit provides a summary of periodic charging

  13. Mathematical modeling of efficacy and safety for anticancer drugs clinical development.

    Science.gov (United States)

    Lavezzi, Silvia Maria; Borella, Elisa; Carrara, Letizia; De Nicolao, Giuseppe; Magni, Paolo; Poggesi, Italo

    2018-01-01

    Drug attrition in oncology clinical development is higher than in other therapeutic areas. In this context, pharmacometric modeling represents a useful tool to explore drug efficacy in earlier phases of clinical development, anticipating overall survival using quantitative model-based metrics. Furthermore, modeling approaches can be used to characterize earlier the safety and tolerability profile of drug candidates, and, thus, the risk-benefit ratio and the therapeutic index, supporting the design of optimal treatment regimens and accelerating the whole process of clinical drug development. Areas covered: Herein, the most relevant mathematical models used in clinical anticancer drug development during the last decade are described. Less recent models were considered in the review if they represent a standard for the analysis of certain types of efficacy or safety measures. Expert opinion: Several mathematical models have been proposed to predict overall survival from earlier endpoints and validate their surrogacy in demonstrating drug efficacy in place of overall survival. An increasing number of mathematical models have also been developed to describe the safety findings. Modeling has been extensively used in anticancer drug development to individualize dosing strategies based on patient characteristics, and design optimal dosing regimens balancing efficacy and safety.

  14. Climate change forecasting in a mountainous data scarce watershed using CMIP5 models under representative concentration pathways

    Science.gov (United States)

    Aghakhani Afshar, A.; Hasanzadeh, Y.; Besalatpour, A. A.; Pourreza-Bilondi, M.

    2017-07-01

    Hydrology cycle of river basins and available water resources in arid and semi-arid regions are highly affected by climate changes. In recent years, the increment of temperature due to excessive increased emission of greenhouse gases has led to an abnormality in the climate system of the earth. The main objective of this study is to survey the future climate changes in one of the biggest mountainous watersheds in northeast of Iran (i.e., Kashafrood). In this research, by considering the precipitation and temperature as two important climatic parameters in watersheds, 14 models evolved in the general circulation models (GCMs) of the newest generation in the Coupled Model Intercomparison Project Phase 5 (CMIP5) were used to forecast the future climate changes in the study area. For the historical period of 1992-2005, four evaluation criteria including Nash-Sutcliffe (NS), percent of bias (PBIAS), coefficient of determination ( R 2) and the ratio of the root-mean-square-error to the standard deviation of measured data (RSR) were used to compare the simulated observed data for assessing goodness-of-fit of the models. In the primary results, four climate models namely GFDL-ESM2G, IPSL-CM5A-MR, MIROC-ESM, and NorESM1-M were selected among the abovementioned 14 models due to their more prediction accuracies to the investigated evaluation criteria. Thereafter, climate changes of the future periods (near-century, 2006-2037; mid-century, 2037-2070; and late-century, 2070-2100) were investigated and compared by four representative concentration pathways (RCPs) of new emission scenarios of RCP2.6, RCP4.5, RCP6.0, and RCP8.5. In order to assess the trend of annual and seasonal changes of climatic components, Mann-Kendall non-parametric test (MK) was also employed. The results of Mann-Kendall test revealed that the precipitation has significant variable trends of both positive and negative alterations. Furthermore, the mean, maximum, and minimum temperature values had

  15. The present and future of cardiac CT in research and clinical practice. Moderated discussion and scientific debate with representatives from the four main vendors

    International Nuclear Information System (INIS)

    Dewey, M.; Vries, H. de; Vries, L. de; Haas, D.; Leidecker, C.

    2010-01-01

    Noninvasive imaging of the heart using computed tomography (CT) is an increasingly important diagnostic approach for patients with known or suspected coronary artery disease. Coronary CT angiography has recently received great attention because it provides imaging of the coronary arteries and quantification of the coronary plaque burden with a spatial and temporal resolution not available with any other noninvasive imaging test. In this moderated scientific debate we discuss the advantages and disadvantages of different technical solutions to CT imaging of the fast moving heart including its small and tortuous coronary arteries. Our discussion goes into the details of developments regarding larger Z-axis coverage (320-row volume CT, high pitch spiral acquisition), improved temporal resolution (dual-source CT, adaptive multi-segment reconstruction, and shorter gantry rotation times with air-bearing gantries), improved spatial resolution (high-definition detectors), and improved reconstruction algorithms (iterative reconstruction, cone beam reconstruction). The discussion also touches on the future technological developments that will be necessary to further improve the acceptance and widespread clinical use of cardiac CT, focusing on radiation exposure reduction and independence from heart rate. Finally, the representatives of the four main vendors explain the most important research projects regarding cardiac CT that they plan to pursue in the near future.

  16. The present and future of cardiac CT in research and clinical practice. Moderated discussion and scientific debate with representatives from the four main vendors

    Energy Technology Data Exchange (ETDEWEB)

    Dewey, M. [Charite Berlin (Germany). Radiology; Vries, H. de [Toshiba Medical Systems Europe, Zoetermeer (Netherlands). CT; Vries, L. de [Philips Medical Systems Europe (Netherlands). CT; Haas, D. [GE Healthcare (Germany). CT; Leidecker, C. [Siemens Medical Solutions (Germany). CT

    2010-04-15

    Noninvasive imaging of the heart using computed tomography (CT) is an increasingly important diagnostic approach for patients with known or suspected coronary artery disease. Coronary CT angiography has recently received great attention because it provides imaging of the coronary arteries and quantification of the coronary plaque burden with a spatial and temporal resolution not available with any other noninvasive imaging test. In this moderated scientific debate we discuss the advantages and disadvantages of different technical solutions to CT imaging of the fast moving heart including its small and tortuous coronary arteries. Our discussion goes into the details of developments regarding larger Z-axis coverage (320-row volume CT, high pitch spiral acquisition), improved temporal resolution (dual-source CT, adaptive multi-segment reconstruction, and shorter gantry rotation times with air-bearing gantries), improved spatial resolution (high-definition detectors), and improved reconstruction algorithms (iterative reconstruction, cone beam reconstruction). The discussion also touches on the future technological developments that will be necessary to further improve the acceptance and widespread clinical use of cardiac CT, focusing on radiation exposure reduction and independence from heart rate. Finally, the representatives of the four main vendors explain the most important research projects regarding cardiac CT that they plan to pursue in the near future.

  17. The Emerging Business Models and Value Proposition of Mobile Health Clinics.

    Science.gov (United States)

    Aung, Khin-Kyemon; Hill, Caterina; Bennet, Jennifer; Song, Zirui; Oriol, Nancy E

    2015-12-01

    Mobile health clinics are increasingly used to deliver healthcare to urban and rural populations. An estimated 2000 vehicles in the United States are now delivering between 5 and 6 million visits annually; however, despite this growth, mobile health clinics represent an underutilized resource that could transform the way healthcare is delivered, especially in underserved areas. Preliminary research has shown that mobile health clinics have the potential to reduce costs and improve health outcomes. Their value lies primarily in their mobility, their ability to be flexibly deployed and customized to fit the evolving needs of populations and health systems, and their ability to link clinical and community settings. Few studies have identified how mobile health clinics can be sustainably utilized. We discuss the value proposition of mobile health clinics and propose 3 potential business models for them-adoption by accountable care organizations, payers, and employers.

  18. Kinetic modeling in pre-clinical positron emission tomography

    Energy Technology Data Exchange (ETDEWEB)

    Kuntner, Claudia [AIT Austrian Institute of Technology GmbH, Seibersdorf (Austria). Biomedical Systems, Health and Environment Dept.

    2014-07-01

    Pre-clinical positron emission tomography (PET) has evolved in the last few years from pure visualization of radiotracer uptake and distribution towards quantification of the physiological parameters. For reliable and reproducible quantification the kinetic modeling methods used to obtain relevant parameters of radiotracer tissue interaction are important. Here we present different kinetic modeling techniques with a focus on compartmental models including plasma input models and reference tissue input models. The experimental challenges of deriving the plasma input function in rodents and the effect of anesthesia are discussed. Finally, in vivo application of kinetic modeling in various areas of pre-clinical research is presented and compared to human data.

  19. CT head-scan dosimetry in an anthropomorphic phantom and associated measurement of ACR accreditation-phantom imaging metrics under clinically representative scan conditions

    Energy Technology Data Exchange (ETDEWEB)

    Brunner, Claudia C.; Stern, Stanley H.; Chakrabarti, Kish [U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, Maryland 20993 (United States); Minniti, Ronaldo [National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, Maryland 20899 (United States); Parry, Marie I. [Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, Maryland 20889 (United States); Skopec, Marlene [National Institutes of Health, 9000 Rockville Pike, Bethesda, Maryland 20892 (United States)

    2013-08-15

    Purpose: To measure radiation absorbed dose and its distribution in an anthropomorphic head phantom under clinically representative scan conditions in three widely used computed tomography (CT) scanners, and to relate those dose values to metrics such as high-contrast resolution, noise, and contrast-to-noise ratio (CNR) in the American College of Radiology CT accreditation phantom.Methods: By inserting optically stimulated luminescence dosimeters (OSLDs) in the head of an anthropomorphic phantom specially developed for CT dosimetry (University of Florida, Gainesville), we measured dose with three commonly used scanners (GE Discovery CT750 HD, Siemens Definition, Philips Brilliance 64) at two different clinical sites (Walter Reed National Military Medical Center, National Institutes of Health). The scanners were set to operate with the same data-acquisition and image-reconstruction protocols as used clinically for typical head scans, respective of the practices of each facility for each scanner. We also analyzed images of the ACR CT accreditation phantom with the corresponding protocols. While the Siemens Definition and the Philips Brilliance protocols utilized only conventional, filtered back-projection (FBP) image-reconstruction methods, the GE Discovery also employed its particular version of an adaptive statistical iterative reconstruction (ASIR) algorithm that can be blended in desired proportions with the FBP algorithm. We did an objective image-metrics analysis evaluating the modulation transfer function (MTF), noise power spectrum (NPS), and CNR for images reconstructed with FBP. For images reconstructed with ASIR, we only analyzed the CNR, since MTF and NPS results are expected to depend on the object for iterative reconstruction algorithms.Results: The OSLD measurements showed that the Siemens Definition and the Philips Brilliance scanners (located at two different clinical facilities) yield average absorbed doses in tissue of 42.6 and 43.1 m

  20. Applying Exploratory Structural Equation Modeling to Examine the Student-Teacher Relationship Scale in a Representative Greek Sample.

    Science.gov (United States)

    Tsigilis, Nikolaos; Gregoriadis, Athanasios; Grammatikopoulos, Vasilis; Zachopoulou, Evridiki

    2018-01-01

    Teacher-child relationships in early childhood are a fundamental prerequisite for children's social, emotional, and academic development. The Student-Teacher Relationship Scale (STRS) is one of the most widely accepted and used instruments that evaluate the quality of teacher-child relationships. STRS is a 28-item questionnaire that assess three relational dimensions, Closeness, Conflict, and Dependency. The relevant literature has shown a pattern regarding the difficulty to support the STRS factor structure with CFA, while it is well-documented with EFA. Recently, a new statistical technique was proposed to combine the best of the CFA and EFA namely, the Exploratory Structural Equation Modeling (ESEM). The purpose of this study was (a) to examine the factor structure of the STRS in a Greek national sample. Toward this end, the ESEM framework was applied in order to overcome the limitations of EFA and CFA, (b) to confirm previous findings about the cultural influence in teacher-child relationship patterns, and (c) to examine the invariance of STRS across gender and age. Early educators from a representative Greek sample size of 535 child care and kindergarten centers completed the STRS for 4,158 children. CFA as well as ESEM procedures were implemented. Results showed that ESEM provided better fit to the data than CFA in both groups, supporting the argument that CFA is an overly restrictive approach in comparison to ESEM for the study of STRS. All primary loadings were statistically significant and were associated with their respective latent factors. Contrary to the existing literature conducted in USA and northern Europe, the association between Closeness and Dependency yielded a positive correlation. This finding is in line with previous studies conducted in Greece and confirm the existence of cultural differences in teacher-child relationships. In addition, findings supported the configural, metric, scalar, and variance/covariance equivalence of the STRS

  1. Applying Exploratory Structural Equation Modeling to Examine the Student-Teacher Relationship Scale in a Representative Greek Sample

    Directory of Open Access Journals (Sweden)

    Nikolaos Tsigilis

    2018-05-01

    Full Text Available Teacher-child relationships in early childhood are a fundamental prerequisite for children's social, emotional, and academic development. The Student-Teacher Relationship Scale (STRS is one of the most widely accepted and used instruments that evaluate the quality of teacher-child relationships. STRS is a 28-item questionnaire that assess three relational dimensions, Closeness, Conflict, and Dependency. The relevant literature has shown a pattern regarding the difficulty to support the STRS factor structure with CFA, while it is well-documented with EFA. Recently, a new statistical technique was proposed to combine the best of the CFA and EFA namely, the Exploratory Structural Equation Modeling (ESEM. The purpose of this study was (a to examine the factor structure of the STRS in a Greek national sample. Toward this end, the ESEM framework was applied in order to overcome the limitations of EFA and CFA, (b to confirm previous findings about the cultural influence in teacher-child relationship patterns, and (c to examine the invariance of STRS across gender and age. Early educators from a representative Greek sample size of 535 child care and kindergarten centers completed the STRS for 4,158 children. CFA as well as ESEM procedures were implemented. Results showed that ESEM provided better fit to the data than CFA in both groups, supporting the argument that CFA is an overly restrictive approach in comparison to ESEM for the study of STRS. All primary loadings were statistically significant and were associated with their respective latent factors. Contrary to the existing literature conducted in USA and northern Europe, the association between Closeness and Dependency yielded a positive correlation. This finding is in line with previous studies conducted in Greece and confirm the existence of cultural differences in teacher-child relationships. In addition, findings supported the configural, metric, scalar, and variance/covariance equivalence of

  2. Understanding the Representative Gut Microbiota Dysbiosis in Metformin-Treated Type 2 Diabetes Patients Using Genome-Scale Metabolic Modeling

    Directory of Open Access Journals (Sweden)

    Dorines Rosario

    2018-06-01

    Full Text Available Dysbiosis in the gut microbiome composition may be promoted by therapeutic drugs such as metformin, the world’s most prescribed antidiabetic drug. Under metformin treatment, disturbances of the intestinal microbes lead to increased abundance of Escherichia spp., Akkermansia muciniphila, Subdoligranulum variabile and decreased abundance of Intestinibacter bartlettii. This alteration may potentially lead to adverse effects on the host metabolism, with the depletion of butyrate producer genus. However, an increased production of butyrate and propionate was verified in metformin-treated Type 2 diabetes (T2D patients. The mechanisms underlying these nutritional alterations and their relation with gut microbiota dysbiosis remain unclear. Here, we used Genome-scale Metabolic Models of the representative gut bacteria Escherichia spp., I. bartlettii, A. muciniphila, and S. variabile to elucidate their bacterial metabolism and its effect on intestinal nutrient pool, including macronutrients (e.g., amino acids and short chain fatty acids, minerals and chemical elements (e.g., iron and oxygen. We applied flux balance analysis (FBA coupled with synthetic lethality analysis interactions to identify combinations of reactions and extracellular nutrients whose absence prevents growth. Our analyses suggest that Escherichia sp. is the bacteria least vulnerable to nutrient availability. We have also examined bacterial contribution to extracellular nutrients including short chain fatty acids, amino acids, and gasses. For instance, Escherichia sp. and S. variabile may contribute to the production of important short chain fatty acids (e.g., acetate and butyrate, respectively involved in the host physiology under aerobic and anaerobic conditions. We have also identified pathway susceptibility to nutrient availability and reaction changes among the four bacteria using both FBA and flux variability analysis. For instance, lipopolysaccharide synthesis, nucleotide sugar

  3. Clinical Predictive Modeling Development and Deployment through FHIR Web Services.

    Science.gov (United States)

    Khalilia, Mohammed; Choi, Myung; Henderson, Amelia; Iyengar, Sneha; Braunstein, Mark; Sun, Jimeng

    2015-01-01

    Clinical predictive modeling involves two challenging tasks: model development and model deployment. In this paper we demonstrate a software architecture for developing and deploying clinical predictive models using web services via the Health Level 7 (HL7) Fast Healthcare Interoperability Resources (FHIR) standard. The services enable model development using electronic health records (EHRs) stored in OMOP CDM databases and model deployment for scoring individual patients through FHIR resources. The MIMIC2 ICU dataset and a synthetic outpatient dataset were transformed into OMOP CDM databases for predictive model development. The resulting predictive models are deployed as FHIR resources, which receive requests of patient information, perform prediction against the deployed predictive model and respond with prediction scores. To assess the practicality of this approach we evaluated the response and prediction time of the FHIR modeling web services. We found the system to be reasonably fast with one second total response time per patient prediction.

  4. Preclinical Murine Models for Lung Cancer: Clinical Trial Applications

    Directory of Open Access Journals (Sweden)

    Amelia Kellar

    2015-01-01

    Full Text Available Murine models for the study of lung cancer have historically been the backbone of preliminary preclinical data to support early human clinical trials. However, the availability of multiple experimental systems leads to debate concerning which model, if any, is best suited for a particular therapeutic strategy. It is imperative that these models accurately predict clinical benefit of therapy. This review provides an overview of the current murine models used to study lung cancer and the advantages and limitations of each model, as well as a retrospective evaluation of the uses of each model with respect to accuracy in predicting clinical benefit of therapy. A better understanding of murine models and their uses, as well as their limitations may aid future research concerning the development and implementation of new targeted therapies and chemotherapeutic agents for lung cancer.

  5. The Stice model of overeating: Tests in clinical and non-clinical samples

    NARCIS (Netherlands)

    Strien, T. van; Engels, R.C.M.E.; Leeuwe, J.F.J. van; Snoek, H.M.

    2005-01-01

    The present study tested the dual pathway model of Stice [Stice, E (1994). A review of the evidence for a sociocultural model of bulimia nervosa and an exploration of the mechanisms of action. Clinical Psychology Review, 14, 633-661 and Stice, E. (2001). A prospective test of the dual-pathway model

  6. A Model for Evaluating Student Clinical Psychomotor Skills.

    Science.gov (United States)

    And Others; Fiel, Nicholas J.

    1979-01-01

    A long-range plan to evaluate medical students' physical examination skills was undertaken at the Ingham Family Medical Clinic at Michigan State University. The development of the psychomotor skills evaluation model to evaluate the skill of blood pressure measurement, tests of the model's reliability, and the use of the model are described. (JMD)

  7. The Pedagogical Reflection Model - an educational perspective on clinical decisions

    DEFF Research Database (Denmark)

    Voergaard Poulsen, Bettina; Vibholm Persson, Stine; Skriver, Mette

    Clinical decision-making is important in patient-centred nursing, which is known in nursing education and research (1) The Pedagogical Reflection Model (PRM) can provide a framework that supports students’ decision-making in patient-specific situations. PRM is based on the assumption that clinical......) The aims of this study were to explore how nurse students and clinical supervisors use PRM as method to reflect before, during and after PRM guidance in relation to clinical decisions in the first year of clinical practice...... decision-making needs to take into account; 1) clinical experiences, 2) the perspective of the patient, 3) clinical observations and investigations, 4) knowledge about patients experiences of being a patient and ill, 5) medical knowledge about diseases, and 6) the organizational framework (2,3,4)(Figure 1...

  8. Modelling representative and coherent Danish farm types based on farm accountancy data for use in enviromental assessments

    DEFF Research Database (Denmark)

    Dalgaard, Randi; Halberg, Niels; Kristensen, Ib S.

    2006-01-01

    There is a need for valid and representative data on the production, resource use and emissions from different farm types in Denmark forpublic regulation and assessment. The data should be usable for both area-based environmental assessment (e.g. nitrate leaching per ha) and product-oriented envi...

  9. Assessing the fit of the Dysphoric Arousal model across two nationally representative epidemiological surveys: The Australian NSMHWB and the United States NESARC.

    Science.gov (United States)

    Armour, Cherie; Carragher, Natacha; Elhai, Jon D

    2013-01-01

    Since the initial inclusion of PTSD in the DSM nomenclature, PTSD symptomatology has been distributed across three symptom clusters. However, a wealth of empirical research has concluded that PTSD's latent structure is best represented by one of two four-factor models: Numbing or Dysphoria. Recently, a newly proposed five-factor Dysphoric Arousal model, which separates the DSM-IV's Arousal cluster into two factors of Anxious Arousal and Dysphoric Arousal, has gathered support across a variety of trauma samples. To date, the Dysphoric Arousal model has not been assessed using nationally representative epidemiological data. We employed confirmatory factor analysis to examine PTSD's latent structure in two independent population based surveys from American (NESARC) and Australia (NSWHWB). We specified and estimated the Numbing model, the Dysphoria model, and the Dysphoric Arousal model in both samples. Results revealed that the Dysphoric Arousal model provided superior fit to the data compared to the alternative models. In conclusion, these findings suggest that items D1-D3 (sleeping difficulties; irritability; concentration difficulties) represent a separate, fifth factor within PTSD's latent structure using nationally representative epidemiological data in addition to single trauma specific samples. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. Assessing the fit of the Dysphoric Arousal model across two nationally representative epidemiological surveys: The Australian NSMHWB and the United States NESARC

    DEFF Research Database (Denmark)

    Armour, C.; Carragher, N.; Elhai, J. D.

    2013-01-01

    samples. Results revealed that the Dysphoric Arousal model provided superior fit to the data compared to the alternative models. In conclusion, these findings suggest that items D1-D3 (sleeping difficulties; irritability; concentration difficulties) represent a separate, fifth factor within PTSD's latent...

  11. Modeling hard clinical end-point data in economic analyses.

    Science.gov (United States)

    Kansal, Anuraag R; Zheng, Ying; Palencia, Roberto; Ruffolo, Antonio; Hass, Bastian; Sorensen, Sonja V

    2013-11-01

    The availability of hard clinical end-point data, such as that on cardiovascular (CV) events among patients with type 2 diabetes mellitus, is increasing, and as a result there is growing interest in using hard end-point data of this type in economic analyses. This study investigated published approaches for modeling hard end-points from clinical trials and evaluated their applicability in health economic models with different disease features. A review of cost-effectiveness models of interventions in clinically significant therapeutic areas (CV diseases, cancer, and chronic lower respiratory diseases) was conducted in PubMed and Embase using a defined search strategy. Only studies integrating hard end-point data from randomized clinical trials were considered. For each study included, clinical input characteristics and modeling approach were summarized and evaluated. A total of 33 articles (23 CV, eight cancer, two respiratory) were accepted for detailed analysis. Decision trees, Markov models, discrete event simulations, and hybrids were used. Event rates were incorporated either as constant rates, time-dependent risks, or risk equations based on patient characteristics. Risks dependent on time and/or patient characteristics were used where major event rates were >1%/year in models with fewer health states (Models of infrequent events or with numerous health states generally preferred constant event rates. The detailed modeling information and terminology varied, sometimes requiring interpretation. Key considerations for cost-effectiveness models incorporating hard end-point data include the frequency and characteristics of the relevant clinical events and how the trial data is reported. When event risk is low, simplification of both the model structure and event rate modeling is recommended. When event risk is common, such as in high risk populations, more detailed modeling approaches, including individual simulations or explicitly time-dependent event rates, are

  12. The Electronic Healthcare Record for Clinical Research (EHR4CR) information model and terminology.

    Science.gov (United States)

    Ouagne, David; Hussain, Sajjad; Sadou, Eric; Jaulent, Marie-Christine; Daniel, Christel

    2012-01-01

    A major barrier to repurposing routinely collected data for clinical research is the heterogeneity of healthcare information systems. Electronic Healthcare Record for Clinical Research (EHR4CR) is a European platform designed to improve the efficiency of conducting clinical trials. In this paper, we propose an initial architecture of the EHR4CR Semantic Interoperability Framework. We used a model-driven engineering approach to build a reference HL7-based multidimensional model bound to a set of reference clinical terminologies acting as a global as view model. We then conducted an evaluation of its expressiveness for patient eligibility. The EHR4CR information model consists in one fact table dedicated to clinical statement and 4 dimensions. The EHR4CR terminology integrates reference terminologies used in patient care (e.g LOINC, ICD-10, SNOMED CT, etc). We used the Object Constraint Language (OCL) to represent patterns of eligibility criteria as constraints on the EHR4CR model to be further transformed in SQL statements executed on different clinical data warehouses.

  13. Clinically relevant morphological structures in breast cancer represent transcriptionally distinct tumor cell populations with varied degrees of epithelial-mesenchymal transition and CD44+CD24- stemness.

    Science.gov (United States)

    Denisov, Evgeny V; Skryabin, Nikolay A; Gerashchenko, Tatiana S; Tashireva, Lubov A; Wilhelm, Jochen; Buldakov, Mikhail A; Sleptcov, Aleksei A; Lebedev, Igor N; Vtorushin, Sergey V; Zavyalova, Marina V; Cherdyntseva, Nadezhda V; Perelmuter, Vladimir M

    2017-09-22

    Intratumor morphological heterogeneity in breast cancer is represented by different morphological structures (tubular, alveolar, solid, trabecular, and discrete) and contributes to poor prognosis; however, the mechanisms involved remain unclear. In this study, we performed 3D imaging, laser microdissection-assisted array comparative genomic hybridization and gene expression microarray analysis of different morphological structures and examined their association with the standard immunohistochemistry scorings and CD44 + CD24 - cancer stem cells. We found that the intratumor morphological heterogeneity is not associated with chromosomal aberrations. By contrast, morphological structures were characterized by specific gene expression profiles and signaling pathways and significantly differed in progesterone receptor and Ki-67 expression. Most importantly, we observed significant differences between structures in the number of expressed genes of the epithelial and mesenchymal phenotypes and the association with cancer invasion pathways. Tubular (tube-shaped) and alveolar (spheroid-shaped) structures were transcriptionally similar and demonstrated co-expression of epithelial and mesenchymal markers. Solid (large shapeless) structures retained epithelial features but demonstrated an increase in mesenchymal traits and collective cell migration hallmarks. Mesenchymal genes and cancer invasion pathways, as well as Ki-67 expression, were enriched in trabecular (one/two rows of tumor cells) and discrete groups (single cells and/or arrangements of 2-5 cells). Surprisingly, the number of CD44 + CD24 - cells was found to be the lowest in discrete groups and the highest in alveolar and solid structures. Overall, our findings indicate the association of intratumor morphological heterogeneity in breast cancer with the epithelial-mesenchymal transition and CD44 + CD24 - stemness and the appeal of this heterogeneity as a model for the study of cancer invasion.

  14. Mayo Clinic Care Network: A Collaborative Health Care Model.

    Science.gov (United States)

    Wald, John T; Lowery-Schrandt, Sherri; Hayes, David L; Kotsenas, Amy L

    2018-01-01

    By leveraging its experience and expertise as a consultative clinical partner, the Mayo Clinic developed an innovative, scalable care model to accomplish several strategic goals: (1) create and sustain high-value relationships that benefit patients and providers, (2) foster relationships with like-minded partners to act as a strategy against the development of narrow health care networks, and (3) increase national and international brand awareness of Mayo Clinic. The result was the Mayo Clinic Care Network. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  15. Clinical trial optimization: Monte Carlo simulation Markov model for planning clinical trials recruitment.

    Science.gov (United States)

    Abbas, Ismail; Rovira, Joan; Casanovas, Josep

    2007-05-01

    The patient recruitment process of clinical trials is an essential element which needs to be designed properly. In this paper we describe different simulation models under continuous and discrete time assumptions for the design of recruitment in clinical trials. The results of hypothetical examples of clinical trial recruitments are presented. The recruitment time is calculated and the number of recruited patients is quantified for a given time and probability of recruitment. The expected delay and the effective recruitment durations are estimated using both continuous and discrete time modeling. The proposed type of Monte Carlo simulation Markov models will enable optimization of the recruitment process and the estimation and the calibration of its parameters to aid the proposed clinical trials. A continuous time simulation may minimize the duration of the recruitment and, consequently, the total duration of the trial.

  16. Is the cluster risk model of parental adversities better than the cumulative risk model as an indicator of childhood physical abuse?: findings from two representative community surveys.

    Science.gov (United States)

    Fuller-Thomson, E; Sawyer, J-L

    2014-01-01

    Screening strategies for childhood physical abuse (CPA) need to be improved in order to identify those most at risk. This study uses two regionally representative community samples to examine whether a cluster or cumulative model of risk indicators (i.e. parental divorce, parental unemployment, and parental addictions) explains a larger proportion of the variation in CPA. Data were drawn from Statistics Canada's National Population Health Survey (1994-1995) and Canadian Community Health Survey 3.1 (2005). Response rates were greater than 80% in both samples. Each survey had approximately 13,000 respondents aged 18 and over who answered questions about the above adverse childhood experiences. A gradient was shown with similar outcomes in each data set. Only 3.4% of adults who experienced none of the three risk indicators reported they had been physically abused during childhood or adolescence. The prevalence of CPA was greater among those who experienced parental divorce alone (8.3%-10.7%), parental unemployment alone (8.9%-9.7%) or parental addictions alone (18.0%-19.5%). When all three risk indicators were present, the prevalence of CPA ranged from 36.0%-41.0% and the age-sex-race adjusted odds were greater than 15 times that of individuals with none of the three risk indicators. The cluster model explained a statistically significantly larger proportion of the variation than the cumulative model although the difference between the two models was modest. For the purposes of parsimony, the cumulative model may be the better alternative. Adults who were exposed to two or more childhood risk indicators were much more likely to report that they were physically abused during their childhood than those with only one or no risk factors. Medical professionals may use this information on cumulative risk factors to more effectively target screening for potential CPA. Future research should include prospective studies. © 2012 John Wiley & Sons Ltd.

  17. Profiling Fast Healthcare Interoperability Resources (FHIR) of Family Health History based on the Clinical Element Models

    OpenAIRE

    Lee, Jaehoon; Hulse, Nathan C.; Wood, Grant M.; Oniki, Thomas A.; Huff, Stanley M.

    2017-01-01

    In this study we developed a Fast Healthcare Interoperability Resources (FHIR) profile to support exchanging a full pedigree based family health history (FHH) information across multiple systems and applications used by clinicians, patients, and researchers. We used previously developed clinical element models (CEMs) that are capable of representing the FHH information, and derived essential data elements including attributes, constraints, and value sets. We analyzed gaps between the FHH CEM ...

  18. Robust Multiscale Modelling Of Two-Phase Steels On Heterogeneous Hardware Infrastructures By Using Statistically Similar Representative Volume Element

    Directory of Open Access Journals (Sweden)

    Rauch Ł.

    2015-09-01

    Full Text Available The coupled finite element multiscale simulations (FE2 require costly numerical procedures in both macro and micro scales. Attempts to improve numerical efficiency are focused mainly on two areas of development, i.e. parallelization/distribution of numerical procedures and simplification of virtual material representation. One of the representatives of both mentioned areas is the idea of Statistically Similar Representative Volume Element (SSRVE. It aims at the reduction of the number of finite elements in micro scale as well as at parallelization of the calculations in micro scale which can be performed without barriers. The simplification of computational domain is realized by transformation of sophisticated images of material microstructure into artificially created simple objects being characterized by similar features as their original equivalents. In existing solutions for two-phase steels SSRVE is created on the basis of the analysis of shape coefficients of hard phase in real microstructure and searching for a representative simple structure with similar shape coefficients. Optimization techniques were used to solve this task. In the present paper local strains and stresses are added to the cost function in optimization. Various forms of the objective function composed of different elements were investigated and used in the optimization procedure for the creation of the final SSRVE. The results are compared as far as the efficiency of the procedure and uniqueness of the solution are considered. The best objective function composed of shape coefficients, as well as of strains and stresses, was proposed. Examples of SSRVEs determined for the investigated two-phase steel using that objective function are demonstrated in the paper. Each step of SSRVE creation is investigated from computational efficiency point of view. The proposition of implementation of the whole computational procedure on modern High Performance Computing (HPC

  19. Bronx Teens Connection's Clinic Linkage Model: Connecting Youth to Quality Sexual and Reproductive Health Care.

    Science.gov (United States)

    O'Uhuru, Deborah J; Santiago, Vivian; Murray, Lauren E; Travers, Madeline; Bedell, Jane F

    2017-03-01

    Teen pregnancy and birth rates in the Bronx have been higher than in New York City, representing a longstanding health disparity. The New York City Department of Health and Mental Hygiene implemented a community-wide, multicomponent intervention to reduce unintended teen pregnancy, the Bronx Teens Connection. The Bronx Teens Connection Clinic Linkage Model sought to increase teens' access to and use of sexual and reproductive health care by increasing community partner capacity to link neighborhood clinics to youth-serving organizations, including schools. The Bronx Teens Connection Clinic Linkage Model used needs assessments, delineated the criteria for linkages, clarified roles and responsibilities of partners and staff, established trainings to support the staff engaged in linkage activities, and developed and used process evaluation methods. Early results demonstrated the strength and feasibility of the model over a 4-year period, with 31 linkages developed and maintained, over 11,300 contacts between clinic health educators and teens completed, and increasing adherence to the Centers for Disease Control and Prevention-defined clinical best practices for adolescent reproductive health. For those eight clinics that were able to provide data, there was a 25% increase in the number of teen clients seen over 4 years. There are many factors that relate to an increase in clinic utilization; some of this increase may have been a result of the linkages between schools and clinics. The Bronx Teens Connection Clinic Linkage Model is an explicit framework for clinical and youth-serving organizations seeking to establish formal linkage relationships that may be useful for other municipalities or organizations. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  20. Statistical properties of fluctuations of time series representing appearances of words in nationwide blog data and their applications: An example of modeling fluctuation scalings of nonstationary time series.

    Science.gov (United States)

    Watanabe, Hayafumi; Sano, Yukie; Takayasu, Hideki; Takayasu, Misako

    2016-11-01

    To elucidate the nontrivial empirical statistical properties of fluctuations of a typical nonsteady time series representing the appearance of words in blogs, we investigated approximately 3×10^{9} Japanese blog articles over a period of six years and analyze some corresponding mathematical models. First, we introduce a solvable nonsteady extension of the random diffusion model, which can be deduced by modeling the behavior of heterogeneous random bloggers. Next, we deduce theoretical expressions for both the temporal and ensemble fluctuation scalings of this model, and demonstrate that these expressions can reproduce all empirical scalings over eight orders of magnitude. Furthermore, we show that the model can reproduce other statistical properties of time series representing the appearance of words in blogs, such as functional forms of the probability density and correlations in the total number of blogs. As an application, we quantify the abnormality of special nationwide events by measuring the fluctuation scalings of 1771 basic adjectives.

  1. Towards representing human behavior and decision making in Earth system models. An overview of techniques and approaches

    NARCIS (Netherlands)

    Müller-Hansen, Finn; Schlüter, Maja; Maes, Michael; Donges, Jonathan F.; Kolb, Jakob J.; Thonicke, Kirsten; Heitzig, Jobst

    2017-01-01

    Today, humans have a critical impact on the Earth system and vice versa, which can generate complex feedback processes between social and ecological dynamics. Integrating human behavior into formal Earth system models (ESMs), however, requires crucial modeling assumptions about actors and their

  2. A semantic-web oriented representation of the clinical element model for secondary use of electronic health records data.

    Science.gov (United States)

    Tao, Cui; Jiang, Guoqian; Oniki, Thomas A; Freimuth, Robert R; Zhu, Qian; Sharma, Deepak; Pathak, Jyotishman; Huff, Stanley M; Chute, Christopher G

    2013-05-01

    The clinical element model (CEM) is an information model designed for representing clinical information in electronic health records (EHR) systems across organizations. The current representation of CEMs does not support formal semantic definitions and therefore it is not possible to perform reasoning and consistency checking on derived models. This paper introduces our efforts to represent the CEM specification using the Web Ontology Language (OWL). The CEM-OWL representation connects the CEM content with the Semantic Web environment, which provides authoring, reasoning, and querying tools. This work may also facilitate the harmonization of the CEMs with domain knowledge represented in terminology models as well as other clinical information models such as the openEHR archetype model. We have created the CEM-OWL meta ontology based on the CEM specification. A convertor has been implemented in Java to automatically translate detailed CEMs from XML to OWL. A panel evaluation has been conducted, and the results show that the OWL modeling can faithfully represent the CEM specification and represent patient data.

  3. Representing soakaways in a physically distributed urban drainage model – Upscaling individual allotments to an aggregated scale

    DEFF Research Database (Denmark)

    Roldin, Maria Kerstin; Mark, Ole; Kuczera, George

    2012-01-01

    the infiltration rate based on water depth and soil properties for each time step, and controls the removal of water from the urban drainage model. The model is intended to be used to assess the impact of soakaways on urban drainage networks. The model is tested using field data and shown to simulate the behavior......The increased load on urban stormwater systems due to climate change and growing urbanization can be partly alleviated by using soakaways and similar infiltration techniques. However, while soakaways are usually small-scale structures, most urban drainage network models operate on a larger spatial...... of individual soakaways well. Six upscaling methods to aggregate individual soakaway units with varying saturated hydraulic conductivity (K) in the surrounding soil have been investigated. In the upscaled model, the weighted geometric mean hydraulic conductivity of individual allotments is found to provide...

  4. A cognitive learning model of clinical nursing leadership.

    Science.gov (United States)

    Pepin, Jacinthe; Dubois, Sylvie; Girard, Francine; Tardif, Jacques; Ha, Laurence

    2011-04-01

    Cognitive modeling of competencies is important to facilitate learning and evaluation. Clinical nursing leadership is considered a competency, as it is a "complex know-act" that students and nurses develop for the quality of care of patients and their families. Previous research on clinical leadership describes the attributes and characteristics of leaders and leadership, but, to our knowledge, a cognitive learning model (CLM) has yet to be developed. The purpose of our research was to develop a CLM of the clinical nursing leadership competency, from the beginning of a nursing program to expertise. An interpretative phenomenological study design was used 1) to document the experience of learning and practicing clinical leadership, and 2) to identify critical-learning turning points. Data was gathered from interviews with 32 baccalaureate students and 21 nurses from two clinical settings. An inductive analysis of data was conducted to determine the learning stages experienced: awareness of clinical leadership in nursing; integration of clinical leadership in actions; active leadership with patient/family; active leadership with the team; and, embedded clinical leadership extended to organizational level and beyond. The resulting CLM could have significant impact on both basic and continuing nursing education. Copyright © 2010 Elsevier Ltd. All rights reserved.

  5. Development and Implementation of a Transversely Isotropic Hyperelastic Constitutive Model With Two Fiber Families to Represent Anisotropic Soft Biological Tissues

    Science.gov (United States)

    2014-06-01

    and XY -plane, respectively. In practice, however, we found even with strict demands on convergence criteria (in the implicit case) or small time steps...however, the geometry of an intervertebral disc or a muscle captured from imaging, may not be the “ elastically neutral” or stress-free reference...given by Ḟ . One early model for muscle was developed by A. V. Hill in 1938 (32). A description of Hill’s model appears in chapter 18 of the textbook

  6. Bond Graph Model of Cerebral Circulation: Toward Clinically Feasible Systemic Blood Flow Simulations

    Science.gov (United States)

    Safaei, Soroush; Blanco, Pablo J.; Müller, Lucas O.; Hellevik, Leif R.; Hunter, Peter J.

    2018-01-01

    We propose a detailed CellML model of the human cerebral circulation that runs faster than real time on a desktop computer and is designed for use in clinical settings when the speed of response is important. A lumped parameter mathematical model, which is based on a one-dimensional formulation of the flow of an incompressible fluid in distensible vessels, is constructed using a bond graph formulation to ensure mass conservation and energy conservation. The model includes arterial vessels with geometric and anatomical data based on the ADAN circulation model. The peripheral beds are represented by lumped parameter compartments. We compare the hemodynamics predicted by the bond graph formulation of the cerebral circulation with that given by a classical one-dimensional Navier-Stokes model working on top of the whole-body ADAN model. Outputs from the bond graph model, including the pressure and flow signatures and blood volumes, are compared with physiological data. PMID:29551979

  7. The Clinical Learning Dyad Model: An Innovation in Midwifery Education.

    Science.gov (United States)

    Cohen, Susanna R; Thomas, Celeste R; Gerard, Claudia

    2015-01-01

    There is a national shortage of women's health and primary care providers in the United States, including certified nurse-midwives and certified midwives. This shortage is directly related to how many students can be trained within the existing system. The current model of midwifery clinical training is based on apprenticeship, with one-on-one interaction between a student and preceptor. Thus, the number of newly trained midwifery providers is limited by the number of available and willing preceptors. The clinical learning dyad model (CLDM), which pairs 2 beginning midwifery students with one preceptor in a busy practice, addresses this problem. In addition, this model brings in a senior midwife student as a near-peer mentor when the students are first oriented into outpatient clinical practice. The model began as a pilot project to improve the quality of training and increase available student spots in clinical education. This article discusses the origins of the model, the specifics of its design, and the results of a midterm and one-year postintervention survey. Students and preceptors involved in this model identified several advantages to the program, including increased student accountability, enhanced socialization into the profession, improved learning, and reduced teaching burden on preceptors. An additional benefit of the CLDM is that students form a learning community and collaborate with preceptors to care for women in busy clinical settings. Challenges of the model will also be discussed. Further research is needed to evaluate the effectiveness of the CLDM. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health. © 2015 by the American College of Nurse-Midwives.

  8. A model for ethical practices in clinical phonetics and linguistics.

    Science.gov (United States)

    Powell, Thomas W

    2007-01-01

    The emergence of clinical phonetics and linguistics as an area of scientific inquiry gives rise to the need for guidelines that define ethical and responsible conduct. The diverse membership of the International Clinical Phonetics and Linguistics Association (ICPLA) and the readership of this journal are uniquely suited to consider ethical issues from diverse perspectives. Accordingly, this paper introduces a multi-tiered six-factor model for ethical practices to stimulate discussion of ethical issues.

  9. ADHD and the externalizing spectrum: direct comparison of categorical, continuous, and hybrid models of liability in a nationally representative sample.

    Science.gov (United States)

    Carragher, Natacha; Krueger, Robert F; Eaton, Nicholas R; Markon, Kristian E; Keyes, Katherine M; Blanco, Carlos; Saha, Tulshi D; Hasin, Deborah S

    2014-08-01

    Alcohol use disorders, substance use disorders, and antisocial personality disorder share a common externalizing liability, which may also include attention-deficit hyperactivity disorder (ADHD). However, few studies have compared formal quantitative models of externalizing liability, with the aim of delineating the categorical and/or continuous nature of this liability in the community. This study compares categorical, continuous, and hybrid models of externalizing liability. Data were derived from the 2004-2005 National Epidemiologic Survey on Alcohol and Related Conditions (N = 34,653). Seven disorders were modeled: childhood ADHD and lifetime diagnoses of antisocial personality disorder (ASPD), nicotine dependence, alcohol dependence, marijuana dependence, cocaine dependence, and other substance dependence. The continuous latent trait model provided the best fit to the data. Measurement invariance analyses supported the fit of the model across genders, with females displaying a significantly lower probability of experiencing externalizing disorders. Cocaine dependence, marijuana dependence, other substance dependence, alcohol dependence, ASPD, nicotine dependence, and ADHD provided the greatest information, respectively, about the underlying externalizing continuum. Liability to externalizing disorders is continuous and dimensional in severity. The findings have important implications for the organizational structure of externalizing psychopathology in psychiatric nomenclatures.

  10. Adding Postal Follow-Up to a Web-Based Survey of Primary Care and Gastroenterology Clinic Physician Chiefs Improved Response Rates but not Response Quality or Representativeness.

    Science.gov (United States)

    Partin, Melissa R; Powell, Adam A; Burgess, Diana J; Haggstrom, David A; Gravely, Amy A; Halek, Krysten; Bangerter, Ann; Shaukat, Aasma; Nelson, David B

    2015-09-01

    This study assessed whether postal follow-up to a web-based physician survey improves response rates, response quality, and representativeness. We recruited primary care and gastroenterology chiefs at 125 Veterans Affairs medical facilities to complete a 10-min web-based survey on colorectal cancer screening and diagnostic practices in 2010. We compared response rates, response errors, and representativeness in the primary care and gastroenterology samples before and after adding postal follow-up. Adding postal follow-up increased response rates by 20-25 percentage points; markedly greater increases than predicted from a third e-mail reminder. In the gastroenterology sample, the mean number of response errors made by web responders (0.25) was significantly smaller than the mean number made by postal responders (2.18), and web responders provided significantly longer responses to open-ended questions. There were no significant differences in these outcomes in the primary care sample. Adequate representativeness was achieved before postal follow-up in both samples, as indicated by the lack of significant differences between web responders and the recruitment population on facility characteristics. We conclude adding postal follow-up to this web-based physician leader survey improved response rates but not response quality or representativeness. © The Author(s) 2013.

  11. OCEANFILMS-2: Representing coadsorption of saccharides in marine films and potential impacts on modeled marine aerosol chemistry

    Energy Technology Data Exchange (ETDEWEB)

    Burrows, Susannah M. [Atmospheric Science and Global Change Division, Pacific Northwest National Laboratory, Richland Washington USA; Gobrogge, Eric [Department of Chemistry and Biochemistry, Montana State University, Bozeman Montana USA; Fu, Li [Environmental and Molecular Sciences Laboratory, Pacific Northwest National Laboratory, Richland Washington USA; Link, Katie [Department of Chemistry and Biochemistry, Montana State University, Bozeman Montana USA; Elliott, Scott M. [Climate, Ocean, and Sea Ice Modelling Group, Los Alamos National Laboratory, Los Alamos New Mexico USA; Wang, Hongfei [Environmental and Molecular Sciences Laboratory, Pacific Northwest National Laboratory, Richland Washington USA; Walker, Rob [Department of Chemistry and Biochemistry, Montana State University, Bozeman Montana USA

    2016-08-10

    Here we show that the addition of chemical interactions of soluble polysaccharides with a surfactant monolayer improves agreement of modeled sea spray chemistry with observed marine aerosol chemistry. In particular, the fraction of hydroxyl functional groups in modeled sea spray organic matter is increased, improving agreement with FTIR observations of marine aerosol composition. The overall organic fraction of submicron sea spray also increases, allowing organic mass fractions in the range 0.5 – 0.7 for submicron sea spray particles over highly active phytoplankton blooms. We show results from Sum Frequency Generation (SFG) experiments that support the modeling approach, by demonstrating that soluble polysaccharides can strongly adsorb to a lipid monolayer via columbic interactions under appropriate conditions.

  12. Design of Dimensional Model for Clinical Data Storage and Analysis

    Directory of Open Access Journals (Sweden)

    Dipankar SENGUPTA

    2013-06-01

    Full Text Available Current research in the field of Life and Medical Sciences is generating chunk of data on daily basis. It has thus become a necessity to find solutions for efficient storage of this data, trying to correlate and extract knowledge from it. Clinical data generated in Hospitals, Clinics & Diagnostics centers is falling under a similar paradigm. Patient’s records in various hospitals are increasing at an exponential rate, thus adding to the problem of data management and storage. Major problem being faced corresponding to storage, is the varied dimensionality of the data, ranging from images to numerical form. Therefore there is a need for development of efficient data model which can handle this multi-dimensionality data issue and store the data with historical aspect.For the stated problem lying in façade of clinical informatics we propose a clinical dimensional model design which can be used for development of a clinical data mart. The model has been designed keeping in consideration temporal storage of patient's data with respect to all possible clinical parameters which can include both textual and image based data. Availability of said data for each patient can be then used for application of data mining techniques for finding the correlation of all the parameters at the level of individual and population.

  13. Representing the acquisition and use of energy by individuals in agent-based models of animal populations

    DEFF Research Database (Denmark)

    Sibly, RS; Grimm, Volker; Johnston, Alice S.A.

    2013-01-01

    of physiological ecology to identify major issues confronting the modeller and to make recommendations about how energy budgets for use in ABMs should be constructed. Our proposal is that modelled animals forage as necessary to supply their energy needs for maintenance, growth and reproduction....... If there is sufficient energy intake, an animal allocates the energy obtained in the order: maintenance, growth, reproduction, energy storage, until its energy stores reach an optimal level. If there is a shortfall, the priorities for maintenance and growth/reproduction remain the same until reserves fall to a critical...

  14. Development of a new mathematical model representing the head region of the adult human for use in internal dose calculations

    International Nuclear Information System (INIS)

    Facioli, L.M.

    1984-01-01

    It is presented a new mathematical model to determine the spatial distribution of the scattered radiation, or specific absorbed fractions, in the head of the adult man. The ALGAM computer code which calculates the internal dose from gamma-ray sources in a man phanton, was modified to include the model proposed. The new program was processed for two source organs: thyroid and brain for 12 incident photon energies ranging from 0.010 to 4.0 MeV. (M.C.K.) [pt

  15. Applying Probabilistic Decision Models to Clinical Trial Design

    Science.gov (United States)

    Smith, Wade P; Phillips, Mark H

    2018-01-01

    Clinical trial design most often focuses on a single or several related outcomes with corresponding calculations of statistical power. We consider a clinical trial to be a decision problem, often with competing outcomes. Using a current controversy in the treatment of HPV-positive head and neck cancer, we apply several different probabilistic methods to help define the range of outcomes given different possible trial designs. Our model incorporates the uncertainties in the disease process and treatment response and the inhomogeneities in the patient population. Instead of expected utility, we have used a Markov model to calculate quality adjusted life expectancy as a maximization objective. Monte Carlo simulations over realistic ranges of parameters are used to explore different trial scenarios given the possible ranges of parameters. This modeling approach can be used to better inform the initial trial design so that it will more likely achieve clinical relevance.

  16. A Model for Clinical Informatics Education for Residents: Addressing an Unmet Need.

    Science.gov (United States)

    Mai, Mark V; Luo, Brooke T; Orenstein, Evan W; Luberti, Anthony A

    2018-04-01

    Opportunities for education in clinical informatics exist throughout the spectrum of formal education extending from high school to postgraduate training. However, physicians in residency represent an underdeveloped source of potential informaticians. Despite the rapid growth of accredited fellowship programs since clinical informatics became a board-eligible subspecialty in 2011, few resident physicians are aware of their role at the intersection of clinical medicine and health information technology or associated opportunities. In an effort to educate and engage residents in clinical informatics, Children's Hospital of Philadelphia has developed a three-pronged model: (1) an elective rotation with hands-on project experience; (2) a longitudinal experience that offers increased exposure and mentorship; and (3) a resident founded and led working group in clinical informatics. We describe resident participation in these initiatives and lessons learned, as well as resident perceptions of how these components have positively influenced informatics knowledge and career choices. Since inception of this model, five residents have pursued the clinical informatics fellowship. This educational model supports resident involvement in hospital-wide informatics efforts with tangible projects and promotes wider engagement through educational opportunities commensurate with the resident's level of interest. Schattauer GmbH Stuttgart.

  17. Preliminary clinical nursing leadership competency model: a qualitative study from Thailand.

    Science.gov (United States)

    Supamanee, Treeyaphan; Krairiksh, Marisa; Singhakhumfu, Laddawan; Turale, Sue

    2011-12-01

    This qualitative study explored the clinical nursing leadership competency perspectives of Thai nurses working in a university hospital. To collect data, in-depth interviews were undertaken with 23 nurse administrators, and focus groups were used with 31 registered nurses. Data were analyzed using content analysis, and theory development was guided by the Iceberg model. Nurses' clinical leadership competencies emerged, comprising hidden characteristics and surface characteristics. The hidden characteristics composed three elements: motive (respect from the nursing and healthcare team and being secure in life), self-concept (representing positive attitudes and values), and traits (personal qualities necessary for leadership). The surface characteristics comprised specific knowledge of nurse leaders about clinical leadership, management and nursing informatics, and clinical skills, such as coordination, effective communication, problem solving, and clinical decision-making. The study findings help nursing to gain greater knowledge of the essence of clinical nursing leadership competencies, a matter critical for theory development in leadership. This study's results later led to the instigation of a training program for registered nurse leaders at the study site, and the formation of a preliminary clinical nursing leadership competency model. © 2011 Blackwell Publishing Asia Pty Ltd.

  18. Improved modeling of clinical data with kernel methods.

    Science.gov (United States)

    Daemen, Anneleen; Timmerman, Dirk; Van den Bosch, Thierry; Bottomley, Cecilia; Kirk, Emma; Van Holsbeke, Caroline; Valentin, Lil; Bourne, Tom; De Moor, Bart

    2012-02-01

    Despite the rise of high-throughput technologies, clinical data such as age, gender and medical history guide clinical management for most diseases and examinations. To improve clinical management, available patient information should be fully exploited. This requires appropriate modeling of relevant parameters. When kernel methods are used, traditional kernel functions such as the linear kernel are often applied to the set of clinical parameters. These kernel functions, however, have their disadvantages due to the specific characteristics of clinical data, being a mix of variable types with each variable its own range. We propose a new kernel function specifically adapted to the characteristics of clinical data. The clinical kernel function provides a better representation of patients' similarity by equalizing the influence of all variables and taking into account the range r of the variables. Moreover, it is robust with respect to changes in r. Incorporated in a least squares support vector machine, the new kernel function results in significantly improved diagnosis, prognosis and prediction of therapy response. This is illustrated on four clinical data sets within gynecology, with an average increase in test area under the ROC curve (AUC) of 0.023, 0.021, 0.122 and 0.019, respectively. Moreover, when combining clinical parameters and expression data in three case studies on breast cancer, results improved overall with use of the new kernel function and when considering both data types in a weighted fashion, with a larger weight assigned to the clinical parameters. The increase in AUC with respect to a standard kernel function and/or unweighted data combination was maximum 0.127, 0.042 and 0.118 for the three case studies. For clinical data consisting of variables of different types, the proposed kernel function--which takes into account the type and range of each variable--has shown to be a better alternative for linear and non-linear classification problems

  19. Toward a normalized clinical drug knowledge base in China-applying the RxNorm model to Chinese clinical drugs.

    Science.gov (United States)

    Wang, Li; Zhang, Yaoyun; Jiang, Min; Wang, Jingqi; Dong, Jiancheng; Liu, Yun; Tao, Cui; Jiang, Guoqian; Zhou, Yi; Xu, Hua

    2018-04-04

    In recent years, electronic health record systems have been widely implemented in China, making clinical data available electronically. However, little effort has been devoted to making drug information exchangeable among these systems. This study aimed to build a Normalized Chinese Clinical Drug (NCCD) knowledge base, by applying and extending the information model of RxNorm to Chinese clinical drugs. Chinese drugs were collected from 4 major resources-China Food and Drug Administration, China Health Insurance Systems, Hospital Pharmacy Systems, and China Pharmacopoeia-for integration and normalization in NCCD. Chemical drugs were normalized using the information model in RxNorm without much change. Chinese patent drugs (i.e., Chinese herbal extracts), however, were represented using an expanded RxNorm model to incorporate the unique characteristics of these drugs. A hybrid approach combining automated natural language processing technologies and manual review by domain experts was then applied to drug attribute extraction, normalization, and further generation of drug names at different specification levels. Lastly, we reported the statistics of NCCD, as well as the evaluation results using several sets of randomly selected Chinese drugs. The current version of NCCD contains 16 976 chemical drugs and 2663 Chinese patent medicines, resulting in 19 639 clinical drugs, 250 267 unique concepts, and 2 602 760 relations. By manual review of 1700 chemical drugs and 250 Chinese patent drugs randomly selected from NCCD (about 10%), we showed that the hybrid approach could achieve an accuracy of 98.60% for drug name extraction and normalization. Using a collection of 500 chemical drugs and 500 Chinese patent drugs from other resources, we showed that NCCD achieved coverages of 97.0% and 90.0% for chemical drugs and Chinese patent drugs, respectively. Evaluation results demonstrated the potential to improve interoperability across various electronic drug systems

  20. A New Model of Clinical Education to Increase Student Placement Availability: The Capacity Development Facilitator Model

    Science.gov (United States)

    Fairbrother, Michele; Nicole, Madelyn; Blackford, Julia; Nagarajan, Srivalli Vilapakkam; McAllister, Lindy

    2016-01-01

    This paper reports on a trial of a new model of clinical education designed to increase student clinical placement availability and address workforce constraints on supervision. The University of Sydney deployed the Capacity Development Facilitators (CDF) in selected Sydney hospitals to work with staff to expand student clinical placement…

  1. Home outdoor models for traffic-related air pollutants do not represent personal exposure measurements in Southern California

    International Nuclear Information System (INIS)

    Ducret-Stich, R; Gemperli, A; Ineichen, A; Phuleria, H C; Delfino, R J; Tjoa, T; Wu, J; Liu, L-J S

    2009-01-01

    Recent studies have used measurements or estimates of traffic-related air pollutants at home or school locations to link associations between exposure and health. However, little is known about the validity of these outdoor concentrations as an estimate for personal exposure to traffic. This paper compares modelled outdoor concentrations at home with personal exposure to traffic air pollution of 63 children in two areas in Los Angeles in 2003/2004. Exposure monitoring consisted of sixteen 10-day monitoring runs, with each run monitoring 4 subjects concurrently with the active personal DataRAM for particulate matter 25 ), elemental carbon (EC) and organic carbon (OC). One child per run had concurrent indoor/outdoor home monitoring. Measurements at central sites (24-hr PM 25 , EC, OC) were taken daily and concentrations of PM 25 , EC, and OC from traffic sources were calculated using the CALINE4 model for individual residences. We modelled outdoor concentrations of PM 2 5 , EC and OC with multilinear regression including GIS and meteorological parameters and adjusted for auto-correlation between repeated measurements. The model fit (R 2 ) for home outdoor estimates was 0.94, 0.74 and 0.80 for PM 25 , EC and OC, respectively. Comparisons between these outdoor estimates and the personal measurements showed a good agreement for PM 25 (R 2 =0.65-0.70) with a mean bias of -0.7±11.8|ag for the smog receptor area, and 18.9±16.2|ag for the traffic impacted area. However the outdoor estimates were not related to personal exposure for EC (R 2 =0.01-0.29) and OC (R 2 =0.03- 0.14). Conclusions: Predictions of outdoor concentrations can be used as approximations of personal exposure to PM 25 . However, they are not appropriate for estimating personal exposure to traffic-related air pollutants including EC and OC in studies of acute exposure-response relationships.

  2. Short communication: Genetic lag represents commercial herd genetic merit more accurately than the 4-path selection model.

    Science.gov (United States)

    Dechow, C D; Rogers, G W

    2018-05-01

    Expectation of genetic merit in commercial dairy herds is routinely estimated using a 4-path genetic selection model that was derived for a closed population, but commercial herds using artificial insemination sires are not closed. The 4-path model also predicts a higher rate of genetic progress in elite herds that provide artificial insemination sires than in commercial herds that use such sires, which counters other theoretical assumptions and observations of realized genetic responses. The aim of this work is to clarify whether genetic merit in commercial herds is more accurately reflected under the assumptions of the 4-path genetic response formula or by a genetic lag formula. We demonstrate by tracing the transmission of genetic merit from parents to offspring that the rate of genetic progress in commercial dairy farms is expected to be the same as that in the genetic nucleus. The lag in genetic merit between the nucleus and commercial farms is a function of sire and dam generation interval, the rate of genetic progress in elite artificial insemination herds, and genetic merit of sires and dams. To predict how strategies such as the use of young versus daughter-proven sires, culling heifers following genomic testing, or selective use of sexed semen will alter genetic merit in commercial herds, genetic merit expectations for commercial herds should be modeled using genetic lag expectations. Copyright © 2018 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  3. Representing Diversity in the Dish: Using Patient-Derived in Vitro Models to Recreate the Heterogeneity of Neurological Disease

    Directory of Open Access Journals (Sweden)

    Layla T. Ghaffari

    2018-02-01

    Full Text Available Neurological diseases, including dementias such as Alzheimer's disease (AD and fronto-temporal dementia (FTD and degenerative motor neuron diseases such as amyotrophic lateral sclerosis (ALS, are responsible for an increasing fraction of worldwide fatalities. Researching these heterogeneous diseases requires models that endogenously express the full array of genetic and epigenetic factors which may influence disease development in both familial and sporadic patients. Here, we discuss the two primary methods of developing patient-derived neurons and glia to model neurodegenerative disease: reprogramming somatic cells into induced pluripotent stem cells (iPSCs, which are differentiated into neurons or glial cells, or directly converting (DC somatic cells into neurons (iNeurons or glial cells. Distinct differentiation techniques for both models result in a variety of neuronal and glial cell types, which have been successful in displaying unique hallmarks of a variety of neurological diseases. Yield, length of differentiation, ease of genetic manipulation, expression of cell-specific markers, and recapitulation of disease pathogenesis are presented as determining factors in how these methods may be used separately or together to ascertain mechanisms of disease and identify therapeutics for distinct patient populations or for specific individuals in personalized medicine projects.

  4. Are Clinical Trial Experiences Utilized?: A Differentiated Model of Medical Sites’ Information Transfer Ability

    DEFF Research Database (Denmark)

    Smed, Marie; Schultz, Carsten; Getz, Kenneth A.

    2015-01-01

    The collaboration with medical professionals in pharmaceutical clinical trials facilitates opportunities to gain valuable market information concerning product functionality issues, as well as issues related to market implementation and adoption. However, previous research on trial management lacks......’ information transfer ability, their methods of communicating, are included. The model is studied on a unique dataset of 395 medical site representatives by applying Rasch scale modeling to differentiate the stickiness of the heterogenic information issues. The results reveal that economic measures...... a differentiated perspective on the potential for information transfer from site to producer. An exploration of the variation in stickiness of information, and therefore the complexity of information transfer in clinical trials, is the main aim of this study. To further enrich the model of the dispersed sites...

  5. Constraining Genome-Scale Models to Represent the Bow Tie Structure of Metabolism for 13C Metabolic Flux Analysis

    Directory of Open Access Journals (Sweden)

    Tyler W. H. Backman

    2018-01-01

    Full Text Available Determination of internal metabolic fluxes is crucial for fundamental and applied biology because they map how carbon and electrons flow through metabolism to enable cell function. 13 C Metabolic Flux Analysis ( 13 C MFA and Two-Scale 13 C Metabolic Flux Analysis (2S- 13 C MFA are two techniques used to determine such fluxes. Both operate on the simplifying approximation that metabolic flux from peripheral metabolism into central “core” carbon metabolism is minimal, and can be omitted when modeling isotopic labeling in core metabolism. The validity of this “two-scale” or “bow tie” approximation is supported both by the ability to accurately model experimental isotopic labeling data, and by experimentally verified metabolic engineering predictions using these methods. However, the boundaries of core metabolism that satisfy this approximation can vary across species, and across cell culture conditions. Here, we present a set of algorithms that (1 systematically calculate flux bounds for any specified “core” of a genome-scale model so as to satisfy the bow tie approximation and (2 automatically identify an updated set of core reactions that can satisfy this approximation more efficiently. First, we leverage linear programming to simultaneously identify the lowest fluxes from peripheral metabolism into core metabolism compatible with the observed growth rate and extracellular metabolite exchange fluxes. Second, we use Simulated Annealing to identify an updated set of core reactions that allow for a minimum of fluxes into core metabolism to satisfy these experimental constraints. Together, these methods accelerate and automate the identification of a biologically reasonable set of core reactions for use with 13 C MFA or 2S- 13 C MFA, as well as provide for a substantially lower set of flux bounds for fluxes into the core as compared with previous methods. We provide an open source Python implementation of these algorithms at https://github.com/JBEI/limitfluxtocore.

  6. Concordant bone marrow involvement of diffuse large B-cell lymphoma represents a distinct clinical and biological entity in the era of immunotherapy

    DEFF Research Database (Denmark)

    Yao, Zhilei; Deng, Lijuan; Xu-Monette, Z Y

    2018-01-01

    In diffuse large B-cell lymphoma (DLBCL), the clinical and biological significance of concordant and discordant bone marrow (BM) involvement have not been well investigated. We evaluated 712 de novo DLBCL patients with front-line rituximab-containing treatment, including 263 patients with positiv...

  7. Advanced Mechanistic 3D Spatial Modeling and Analysis Methods to Accurately Represent Nuclear Facility External Event Scenarios

    Energy Technology Data Exchange (ETDEWEB)

    Sezen, Halil [The Ohio State Univ., Columbus, OH (United States). Dept. of Civil, Environmental and Geodetic Engineering; Aldemir, Tunc [The Ohio State Univ., Columbus, OH (United States). College of Engineering, Nuclear Engineering Program, Dept. of Mechanical and Aerospace Engineering; Denning, R. [The Ohio State Univ., Columbus, OH (United States); Vaidya, N. [Rizzo Associates, Pittsburgh, PA (United States)

    2017-12-29

    Probabilistic risk assessment of nuclear power plants initially focused on events initiated by internal faults at the plant, rather than external hazards including earthquakes and flooding. Although the importance of external hazards risk analysis is now well recognized, the methods for analyzing low probability external hazards rely heavily on subjective judgment of specialists, often resulting in substantial conservatism. This research developed a framework to integrate the risk of seismic and flooding events using realistic structural models and simulation of response of nuclear structures. The results of four application case studies are presented.

  8. [Application of three compartment model and response surface model to clinical anesthesia using Microsoft Excel].

    Science.gov (United States)

    Abe, Eiji; Abe, Mari

    2011-08-01

    With the spread of total intravenous anesthesia, clinical pharmacology has become more important. We report Microsoft Excel file applying three compartment model and response surface model to clinical anesthesia. On the Microsoft Excel sheet, propofol, remifentanil and fentanyl effect-site concentrations are predicted (three compartment model), and probabilities of no response to prodding, shaking, surrogates of painful stimuli and laryngoscopy are calculated using predicted effect-site drug concentration. Time-dependent changes in these calculated values are shown graphically. Recent development in anesthetic drug interaction studies are remarkable, and its application to clinical anesthesia with this Excel file is simple and helpful for clinical anesthesia.

  9. Characterisation of model compounds and a synthetic coal by TG/MS/FTIR to represent the pyrolysis behaviour of coal

    Energy Technology Data Exchange (ETDEWEB)

    Arenillas, A.; Pevida, C.; Rubiera, F.; Garcia, R.; Pis, J.J. [Instituto Nacional del Carbon, CSIC, Apartado 73, 33080 Oviedo (Spain)

    2004-06-01

    Coal pyrolysis is the initial, accompanying reaction of a number of coal conversion processes such as hydrogenation, combustion and gasification. However, because of the inherent complexity of coal composition, it is difficult to describe coal pyrolysis clearly. Single model compounds have been used before in order to provide additional insight into the complex processes that occur in the pyrolysis of coal. Yet the picture obtained is a simplified one and certain important aspects such as coal structure, interactions between different surface groups and cross-links are omitted. The approach used in this work involves the preparation of a synthetic coal, SC, with a known structure by curing a mixture of single, well-defined model compounds. By means of chemical characterisation, the SC was shown to contain the macroscopic features of a high volatile coal (proximate and ultimate analyses). FTIR characterisation revealed the presence of functional groups similar to those of coal in the structure of the SC. Temperature-programmed pyrolysis tests were performed in a thermobalance linked to a mass spectrometer and a Fourier transform infrared analyser (TG/MS/FTIR). The thermal behaviour of the synthetic coal (i.e., rate of mass loss and the evolution profiles of gaseous compounds during pyrolysis tests) is very similar to that of the high volatile bituminous coal which was used as a reference material. The great advantage of using SC lies in the fact that its composition and structure can be accurately determined and employed in subsequent applications in basic and mechanistic studies.

  10. Assessing biocomputational modelling in transforming clinical guidelines for osteoporosis management.

    Science.gov (United States)

    Thiel, Rainer; Viceconti, Marco; Stroetmann, Karl

    2011-01-01

    Biocomputational modelling as developed by the European Virtual Physiological Human (VPH) Initiative is the area of ICT most likely to revolutionise in the longer term the practice of medicine. Using the example of osteoporosis management, a socio-economic assessment framework is presented that captures how the transformation of clinical guidelines through VPH models can be evaluated. Applied to the Osteoporotic Virtual Physiological Human Project, a consequent benefit-cost analysis delivers promising results, both methodologically and substantially.

  11. Statistical model based gender prediction for targeted NGS clinical panels

    Directory of Open Access Journals (Sweden)

    Palani Kannan Kandavel

    2017-12-01

    The reference test dataset are being used to test the model. The sensitivity on predicting the gender has been increased from the current “genotype composition in ChrX” based approach. In addition, the prediction score given by the model can be used to evaluate the quality of clinical dataset. The higher prediction score towards its respective gender indicates the higher quality of sequenced data.

  12. Model Comparison for Breast Cancer Prognosis Based on Clinical Data.

    Directory of Open Access Journals (Sweden)

    Sabri Boughorbel

    Full Text Available We compared the performance of several prediction techniques for breast cancer prognosis, based on AU-ROC performance (Area Under ROC for different prognosis periods. The analyzed dataset contained 1,981 patients and from an initial 25 variables, the 11 most common clinical predictors were retained. We compared eight models from a wide spectrum of predictive models, namely; Generalized Linear Model (GLM, GLM-Net, Partial Least Square (PLS, Support Vector Machines (SVM, Random Forests (RF, Neural Networks, k-Nearest Neighbors (k-NN and Boosted Trees. In order to compare these models, paired t-test was applied on the model performance differences obtained from data resampling. Random Forests, Boosted Trees, Partial Least Square and GLMNet have superior overall performance, however they are only slightly higher than the other models. The comparative analysis also allowed us to define a relative variable importance as the average of variable importance from the different models. Two sets of variables are identified from this analysis. The first includes number of positive lymph nodes, tumor size, cancer grade and estrogen receptor, all has an important influence on model predictability. The second set incudes variables related to histological parameters and treatment types. The short term vs long term contribution of the clinical variables are also analyzed from the comparative models. From the various cancer treatment plans, the combination of Chemo/Radio therapy leads to the largest impact on cancer prognosis.

  13. Representative-Sandwich Model for Mechanical-Crush and Short-Circuit Simulation of Lithium-ion Batteries

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Chao; Santhanagopalan, Shriram; Sprague, Michael A.; Pesaran, Ahmad A.

    2015-07-28

    Lithium-ion batteries are currently the state-of-the-art power sources for a variety of applications, from consumer electronic devices to electric-drive vehicles (EDVs). Being an energized component, failure of the battery is an essential concern, which can result in rupture, smoke, fire, or venting. The failure of Lithium-ion batteries can be due to a number of external abusive conditions (impact/crush, overcharge, thermal ramp, etc.) or internal conditions (internal short circuits, excessive heating due to resistance build-up, etc.), of which the mechanical-abuse-induced short circuit is a very practical problem. In order to better understand the behavior of Lithium-ion batteries under mechanical abuse, a coupled modeling methodology encompassing the mechanical, thermal and electrical response has been developed for predicting short circuit under external crush.

  14. The effect of winglets on the static aerodynamic stability characteristics of a representative second generation jet transport model

    Science.gov (United States)

    Jacobs, P. F.; Flechner, S. G.

    1976-01-01

    A baseline wing and a version of the same wing fitted with winglets were tested. The longitudinal aerodynamic characteristics were determined through an angle-of-attack range from -1 deg to 10 deg at an angle of sideslip of 0 deg for Mach numbers of 0.750, 0.800, and 0.825. The lateral aerodynamic characteristics were determined through the same angle-of-attack range at fixed sideslip angles of 2.5 deg and 5 deg. Both configurations were investigated at Reynolds numbers of 13,000,000, per meter (4,000,000 per foot) and approximately 20,000,000 per meter (6,000,000 per foot). The winglet configuration showed slight increases over the baseline wing in static longitudinal and lateral aerodynamic stability throughout the test Mach number range for a model design lift coefficient of 0.53. Reynolds number variation had very little effect on stability.

  15. Clinical Reasoning in Athletic Training Education: Modeling Expert Thinking

    Science.gov (United States)

    Geisler, Paul R.; Lazenby, Todd W.

    2009-01-01

    Objective: To address the need for a more definitive approach to critical thinking during athletic training educational experiences by introducing the clinical reasoning model for critical thinking. Background: Educators are aware of the need to teach students how to think critically. The multiple domains of athletic training are comprehensive and…

  16. Creating a system of medical and psychological rehabilitation of extreme professions representatives (firemen-rescuers as a model

    Directory of Open Access Journals (Sweden)

    J. Chumaeva

    2015-08-01

    2Odessa National Maritime Academy, Odessa, Ukraine   Abstract Background. Working conditions of representatives of extreme professions (firemen-rescuers are a good example, are connected with disregulations and disorders of physiologic functions, fatigue accumulation and disadaptation. The medical and psychological rehabilitation is an effective way for occupational health and reliability restoration. However, last one is characterized by an empirical approach and conducted by priority of medical component, that significantly reduces effectiveness of the undertaken measures. So, it is necessary to develop a system of combined medical and psychological rehabilitation (MPR. Materials and methods. In this progect MPR was carried out in 238 specialists of three professional groups:  firemen-rescuers (146, fire-engine drivers (44 and inspectors of fire safety (48 - control. Psychophysiological examination included the computerized program “MORTEST”, variant “SPAS-14” performance, answers to the individual-typological questionnaire (ITQ and Eysenck personal test (EPT. The levels of epinephrine (Е, norepinephrine (NЕ, dopamine (DА  and dioxyphenylalanine (DOPA urinal excretion, the vanillylmandelic (VMA and homovanillic acids (HVA levels in urine were also defined. The survey is conducted three times: at the beginning, middle and the end of a 12-day rehabilitation course. Statistical data processing  was carried out by common programs in  Microsoft Excel. Results and discussion. The studies have shown that the attributes to identify individual-typological differences are indicators of extroversion-introversion and anxiety in tests ITO and EPT. The results  were divided into three clusters: extroverts with low anxiety (52.9%; ambiverts with low (27.7% and high anxiety (19.4%. Simultaneously it was assigned different types of SAS response in the rehabilitation process: basic or balanced, epinephrinic, norepinephrinic, and with low secretory activity. Low

  17. Clinical laboratory as an economic model for business performance analysis.

    Science.gov (United States)

    Buljanović, Vikica; Patajac, Hrvoje; Petrovecki, Mladen

    2011-08-15

    To perform SWOT (strengths, weaknesses, opportunities, and threats) analysis of a clinical laboratory as an economic model that may be used to improve business performance of laboratories by removing weaknesses, minimizing threats, and using external opportunities and internal strengths. Impact of possible threats to and weaknesses of the Clinical Laboratory at Našice General County Hospital business performance and use of strengths and opportunities to improve operating profit were simulated using models created on the basis of SWOT analysis results. The operating profit as a measure of profitability of the clinical laboratory was defined as total revenue minus total expenses and presented using a profit and loss account. Changes in the input parameters in the profit and loss account for 2008 were determined using opportunities and potential threats, and economic sensitivity analysis was made by using changes in the key parameters. The profit and loss account and economic sensitivity analysis were tools for quantifying the impact of changes in the revenues and expenses on the business operations of clinical laboratory. Results of simulation models showed that operational profit of €470 723 in 2008 could be reduced to only €21 542 if all possible threats became a reality and current weaknesses remained the same. Also, operational gain could be increased to €535 804 if laboratory strengths and opportunities were utilized. If both the opportunities and threats became a reality, the operational profit would decrease by €384 465. The operational profit of the clinical laboratory could be significantly reduced if all threats became a reality and the current weaknesses remained the same. The operational profit could be increased by utilizing strengths and opportunities as much as possible. This type of modeling may be used to monitor business operations of any clinical laboratory and improve its financial situation by implementing changes in the next fiscal

  18. Clinical laboratory as an economic model for business performance analysis

    Science.gov (United States)

    Buljanović, Vikica; Patajac, Hrvoje; Petrovečki, Mladen

    2011-01-01

    Aim To perform SWOT (strengths, weaknesses, opportunities, and threats) analysis of a clinical laboratory as an economic model that may be used to improve business performance of laboratories by removing weaknesses, minimizing threats, and using external opportunities and internal strengths. Methods Impact of possible threats to and weaknesses of the Clinical Laboratory at Našice General County Hospital business performance and use of strengths and opportunities to improve operating profit were simulated using models created on the basis of SWOT analysis results. The operating profit as a measure of profitability of the clinical laboratory was defined as total revenue minus total expenses and presented using a profit and loss account. Changes in the input parameters in the profit and loss account for 2008 were determined using opportunities and potential threats, and economic sensitivity analysis was made by using changes in the key parameters. The profit and loss account and economic sensitivity analysis were tools for quantifying the impact of changes in the revenues and expenses on the business operations of clinical laboratory. Results Results of simulation models showed that operational profit of €470 723 in 2008 could be reduced to only €21 542 if all possible threats became a reality and current weaknesses remained the same. Also, operational gain could be increased to €535 804 if laboratory strengths and opportunities were utilized. If both the opportunities and threats became a reality, the operational profit would decrease by €384 465. Conclusion The operational profit of the clinical laboratory could be significantly reduced if all threats became a reality and the current weaknesses remained the same. The operational profit could be increased by utilizing strengths and opportunities as much as possible. This type of modeling may be used to monitor business operations of any clinical laboratory and improve its financial situation by

  19. A consensus for the development of a vector model to assess clinical complexity.

    Science.gov (United States)

    Corazza, Gino Roberto; Klersy, Catherine; Formagnana, Pietro; Lenti, Marco Vincenzo; Padula, Donatella

    2017-12-01

    The progressive rise in multimorbidity has made management of complex patients one of the most topical and challenging issues in medicine, both in clinical practice and for healthcare organizations. To make this easier, a score of clinical complexity (CC) would be useful. A vector model to evaluate biological and extra-biological (socio-economic, cultural, behavioural, environmental) domains of CC was proposed a few years ago. However, given that the variables that grade each domain had never been defined, this model has never been used in clinical practice. To overcome these limits, a consensus meeting was organised to grade each domain of CC, and to establish the hierarchy of the domains. A one-day consensus meeting consisting of a multi-professional panel of 25 people was held at our Hospital. In a preliminary phase, the proponents selected seven variables as qualifiers for each of the five above-mentioned domains. In the course of the meeting, the panel voted for five variables considered to be the most representative for each domain. Consensus was established with 2/3 agreement, and all variables were dichotomised. Finally, the various domains were parametrized and ranked within a feasible vector model. A Clinical Complexity Index was set up using the chosen variables. All the domains were graphically represented through a vector model: the biological domain was chosen as the most significant (highest slope), followed by the behavioural and socio-economic domains (intermediate slope), and lastly by the cultural and environmental ones (lowest slope). A feasible and comprehensive tool to evaluate CC in clinical practice is proposed herein.

  20. Memory binding in clinical and non-clinical psychotic experiences: how does the continuum model fare?

    Science.gov (United States)

    Chhabra, S; Badcock, J C; Maybery, M T

    2013-07-01

    Both clinical and non-clinical auditory hallucinations (AH) have been associated with source memory deficits, supporting a continuum of underlying cognitive mechanisms, though few studies have employed the same task in patient and nonpatient samples. Recent commentators have called for more debate on the continuum model of psychosis. Consequently, the current study investigated the continuity model of AH with reference to memory binding. We used an identical voice and word recognition memory task to assess binding in two separate studies of: (1) healthy hallucination-prone individuals and controls (30 high and 30 low scorers on the Launay-Slade Hallucination Scale-Revised) and (2) schizophrenia patient samples (32 with AH, 32 without AH) and 32 healthy controls. There was no evidence of impaired binding in high hallucination-prone, compared to low hallucination-prone individuals. In contrast, individuals with schizophrenia (both with and without AH) had difficulties binding (remembering "who said what"), alongside difficulties remembering individual words and voices. Binding ability and memory for voices were also negatively linked to the loudness of hallucinated voices reported by patients with AH. These findings suggest that different mechanisms may exist in clinical and non-clinical hallucinators, adding to the growing debate on the continuum model of psychotic symptoms.

  1. Unintentional Interpersonal Synchronization Represented as a Reciprocal Visuo-Postural Feedback System: A Multivariate Autoregressive Modeling Approach.

    Directory of Open Access Journals (Sweden)

    Shuntaro Okazaki

    Full Text Available People's behaviors synchronize. It is difficult, however, to determine whether synchronized behaviors occur in a mutual direction--two individuals influencing one another--or in one direction--one individual leading the other, and what the underlying mechanism for synchronization is. To answer these questions, we hypothesized a non-leader-follower postural sway synchronization, caused by a reciprocal visuo-postural feedback system operating on pairs of individuals, and tested that hypothesis both experimentally and via simulation. In the behavioral experiment, 22 participant pairs stood face to face either 20 or 70 cm away from each other wearing glasses with or without vision blocking lenses. The existence and direction of visual information exchanged between pairs of participants were systematically manipulated. The time series data for the postural sway of these pairs were recorded and analyzed with cross correlation and causality. Results of cross correlation showed that postural sway of paired participants was synchronized, with a shorter time lag when participant pairs could see one another's head motion than when one of the participants was blindfolded. In addition, there was less of a time lag in the observed synchronization when the distance between participant pairs was smaller. As for the causality analysis, noise contribution ratio (NCR, the measure of influence using a multivariate autoregressive model, was also computed to identify the degree to which one's postural sway is explained by that of the other's and how visual information (sighted vs. blindfolded interacts with paired participants' postural sway. It was found that for synchronization to take place, it is crucial that paired participants be sighted and exert equal influence on one another by simultaneously exchanging visual information. Furthermore, a simulation for the proposed system with a wider range of visual input showed a pattern of results similar to the

  2. A musculoskeletal foot model for clinical gait analysis.

    Science.gov (United States)

    Saraswat, Prabhav; Andersen, Michael S; Macwilliams, Bruce A

    2010-06-18

    Several full body musculoskeletal models have been developed for research applications and these models may potentially be developed into useful clinical tools to assess gait pathologies. Existing full-body musculoskeletal models treat the foot as a single segment and ignore the motions of the intrinsic joints of the foot. This assumption limits the use of such models in clinical cases with significant foot deformities. Therefore, a three-segment musculoskeletal model of the foot was developed to match the segmentation of a recently developed multi-segment kinematic foot model. All the muscles and ligaments of the foot spanning the modeled joints were included. Muscle pathways were adjusted with an optimization routine to minimize the difference between the muscle flexion-extension moment arms from the model and moment arms reported in literature. The model was driven by walking data from five normal pediatric subjects (aged 10.6+/-1.57 years) and muscle forces and activation levels required to produce joint motions were calculated using an inverse dynamic analysis approach. Due to the close proximity of markers on the foot, small marker placement error during motion data collection may lead to significant differences in musculoskeletal model outcomes. Therefore, an optimization routine was developed to enforce joint constraints, optimally scale each segment length and adjust marker positions. To evaluate the model outcomes, the muscle activation patterns during walking were compared with electromyography (EMG) activation patterns reported in the literature. Model-generated muscle activation patterns were observed to be similar to the EMG activation patterns. Published by Elsevier Ltd.

  3. Modeling framework for representing long-term effectiveness of best management practices in addressing hydrology and water quality problems: Framework development and demonstration using a Bayesian method

    Science.gov (United States)

    Liu, Yaoze; Engel, Bernard A.; Flanagan, Dennis C.; Gitau, Margaret W.; McMillan, Sara K.; Chaubey, Indrajeet; Singh, Shweta

    2018-05-01

    Best management practices (BMPs) are popular approaches used to improve hydrology and water quality. Uncertainties in BMP effectiveness over time may result in overestimating long-term efficiency in watershed planning strategies. To represent varying long-term BMP effectiveness in hydrologic/water quality models, a high level and forward-looking modeling framework was developed. The components in the framework consist of establishment period efficiency, starting efficiency, efficiency for each storm event, efficiency between maintenance, and efficiency over the life cycle. Combined, they represent long-term efficiency for a specific type of practice and specific environmental concern (runoff/pollutant). An approach for possible implementation of the framework was discussed. The long-term impacts of grass buffer strips (agricultural BMP) and bioretention systems (urban BMP) in reducing total phosphorus were simulated to demonstrate the framework. Data gaps were captured in estimating the long-term performance of the BMPs. A Bayesian method was used to match the simulated distribution of long-term BMP efficiencies with the observed distribution with the assumption that the observed data represented long-term BMP efficiencies. The simulated distribution matched the observed distribution well with only small total predictive uncertainties. With additional data, the same method can be used to further improve the simulation results. The modeling framework and results of this study, which can be adopted in hydrologic/water quality models to better represent long-term BMP effectiveness, can help improve decision support systems for creating long-term stormwater management strategies for watershed management projects.

  4. Multiscale Modeling in the Clinic: Drug Design and Development

    Energy Technology Data Exchange (ETDEWEB)

    Clancy, Colleen E.; An, Gary; Cannon, William R.; Liu, Yaling; May, Elebeoba E.; Ortoleva, Peter; Popel, Aleksander S.; Sluka, James P.; Su, Jing; Vicini, Paolo; Zhou, Xiaobo; Eckmann, David M.

    2016-02-17

    A wide range of length and time scales are relevant to pharmacology, especially in drug development, drug design and drug delivery. Therefore, multi-scale computational modeling and simulation methods and paradigms that advance the linkage of phenomena occurring at these multiple scales have become increasingly important. Multi-scale approaches present in silico opportunities to advance laboratory research to bedside clinical applications in pharmaceuticals research. This is achievable through the capability of modeling to reveal phenomena occurring across multiple spatial and temporal scales, which are not otherwise readily accessible to experimentation. The resultant models, when validated, are capable of making testable predictions to guide drug design and delivery. In this review we describe the goals, methods, and opportunities of multi-scale modeling in drug design and development. We demonstrate the impact of multiple scales of modeling in this field. We indicate the common mathematical techniques employed for multi-scale modeling approaches used in pharmacology and present several examples illustrating the current state-of-the-art regarding drug development for: Excitable Systems (Heart); Cancer (Metastasis and Differentiation); Cancer (Angiogenesis and Drug Targeting); Metabolic Disorders; and Inflammation and Sepsis. We conclude with a focus on barriers to successful clinical translation of drug development, drug design and drug delivery multi-scale models.

  5. A Typology for Modeling Processes in Clinical Guidelines and Protocols

    Science.gov (United States)

    Tu, Samson W.; Musen, Mark A.

    We analyzed the graphical representations that are used by various guideline-modeling methods to express process information embodied in clinical guidelines and protocols. From this analysis, we distilled four modeling formalisms and the processes they typically model: (1) flowcharts for capturing problem-solving processes, (2) disease-state maps that link decision points in managing patient problems over time, (3) plans that specify sequences of activities that contribute toward a goal, (4) workflow specifications that model care processes in an organization. We characterized the four approaches and showed that each captures some aspect of what a guideline may specify. We believe that a general guideline-modeling system must provide explicit representation for each type of process.

  6. Augment clinical measurement using a constraint-based esophageal model

    Science.gov (United States)

    Kou, Wenjun; Acharya, Shashank; Kahrilas, Peter; Patankar, Neelesh; Pandolfino, John

    2017-11-01

    Quantifying the mechanical properties of the esophageal wall is crucial to understanding impairments of trans-esophageal flow characteristic of several esophageal diseases. However, these data are unavailable owing to technological limitations of current clinical diagnostic instruments that instead display esophageal luminal cross sectional area based on intraluminal impedance change. In this work, we developed an esophageal model to predict bolus flow and the wall property based on clinical measurements. The model used the constraint-based immersed-boundary method developed previously by our group. Specifically, we first approximate the time-dependent wall geometry based on impedance planimetry data on luminal cross sectional area. We then fed these along with pressure data into the model and computed wall tension based on simulated pressure and flow fields, and the material property based on the strain-stress relationship. As examples, we applied this model to augment FLIP (Functional Luminal Imaging Probe) measurements in three clinical cases: a normal subject, achalasia, and eosinophilic esophagitis (EoE). Our findings suggest that the wall stiffness was greatest in the EoE case, followed by the achalasia case, and then the normal. This is supported by NIH Grant R01 DK56033 and R01 DK079902.

  7. A methodology for eliciting, representing, and analysing stakeholder knowledge for decision making on complex socio-ecological systems: from cognitive maps to agent-based models.

    Science.gov (United States)

    Elsawah, Sondoss; Guillaume, Joseph H A; Filatova, Tatiana; Rook, Josefine; Jakeman, Anthony J

    2015-03-15

    This paper aims to contribute to developing better ways for incorporating essential human elements in decision making processes for modelling of complex socio-ecological systems. It presents a step-wise methodology for integrating perceptions of stakeholders (qualitative) into formal simulation models (quantitative) with the ultimate goal of improving understanding and communication about decision making in complex socio-ecological systems. The methodology integrates cognitive mapping and agent based modelling. It cascades through a sequence of qualitative/soft and numerical methods comprising: (1) Interviews to elicit mental models; (2) Cognitive maps to represent and analyse individual and group mental models; (3) Time-sequence diagrams to chronologically structure the decision making process; (4) All-encompassing conceptual model of decision making, and (5) computational (in this case agent-based) Model. We apply the proposed methodology (labelled ICTAM) in a case study of viticulture irrigation in South Australia. Finally, we use strengths-weakness-opportunities-threats (SWOT) analysis to reflect on the methodology. Results show that the methodology leverages the use of cognitive mapping to capture the richness of decision making and mental models, and provides a combination of divergent and convergent analysis methods leading to the construction of an Agent Based Model. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Selection of a representative subset of global climate models that captures the profile of regional changes for integrated climate impacts assessment

    Directory of Open Access Journals (Sweden)

    Alex C. Ruane

    2017-03-01

    Full Text Available Abstract We present the Representative Temperature and Precipitation (T&P GCM Subsetting Approach developed within the Agricultural Model Intercomparison and Improvement Project (AgMIP to select a practical subset of global climate models (GCMs for regional integrated assessment of climate impacts when resource limitations do not permit the full ensemble of GCMs to be evaluated given the need to also focus on impacts sector and economics models. Subsetting inherently leads to a loss of information but can free up resources to explore important uncertainties in the integrated assessment that would otherwise be prohibitive. The Representative T&P GCM Subsetting Approach identifies five individual GCMs that capture a profile of the full ensemble of temperature and precipitation change within the growing season while maintaining information about the probability that basic classes of climate changes (relatively cool/wet, cool/dry, middle, hot/wet, and hot/dry are projected in the full GCM ensemble. We demonstrate the selection methodology for maize impacts in Ames, Iowa, and discuss limitations and situations when additional information may be required to select representative GCMs. We then classify 29 GCMs over all land areas to identify regions and seasons with characteristic diagonal skewness related to surface moisture as well as extreme skewness connected to snow-albedo feedbacks and GCM uncertainty. Finally, we employ this basic approach to recognize that GCM projections demonstrate coherence across space, time, and greenhouse gas concentration pathway. The Representative T&P GCM Subsetting Approach provides a quantitative basis for the determination of useful GCM subsets, provides a practical and coherent approach where previous assessments selected solely on availability of scenarios, and may be extended for application to a range of scales and sectoral impacts.

  9. The Assessment of Patient Clinical Outcome: Advantages, Models, Features of an Ideal Model

    Directory of Open Access Journals (Sweden)

    Mou’ath Hourani

    2016-06-01

    Full Text Available Background: The assessment of patient clinical outcome focuses on measuring various aspects of the health status of a patient who is under healthcare intervention. Patient clinical outcome assessment is a very significant process in the clinical field as it allows health care professionals to better understand the effectiveness of their health care programs and thus for enhancing the health care quality in general. It is thus vital that a high quality, informative review of current issues regarding the assessment of patient clinical outcome should be conducted. Aims & Objectives: 1 Summarizes the advantages of the assessment of patient clinical outcome; 2 reviews some of the existing patient clinical outcome assessment models namely: Simulation, Markov, Bayesian belief networks, Bayesian statistics and Conventional statistics, and Kaplan-Meier analysis models; and 3 demonstrates the desired features that should be fulfilled by a well-established ideal patient clinical outcome assessment model. Material & Methods: An integrative review of the literature has been performed using the Google Scholar to explore the field of patient clinical outcome assessment. Conclusion: This paper will directly support researchers, clinicians and health care professionals in their understanding of developments in the domain of the assessment of patient clinical outcome, thus enabling them to propose ideal assessment models.

  10. The Assessment of Patient Clinical Outcome: Advantages, Models, Features of an Ideal Model

    Directory of Open Access Journals (Sweden)

    Mou’ath Hourani

    2016-06-01

    Full Text Available Background: The assessment of patient clinical outcome focuses on measuring various aspects of the health status of a patient who is under healthcare intervention. Patient clinical outcome assessment is a very significant process in the clinical field as it allows health care professionals to better understand the effectiveness of their health care programs and thus for enhancing the health care quality in general. It is thus vital that a high quality, informative review of current issues regarding the assessment of patient clinical outcome should be conducted. Aims & Objectives: 1 Summarizes the advantages of the assessment of patient clinical outcome; 2 reviews some of the existing patient clinical outcome assessment models namely: Simulation, Markov, Bayesian belief networks, Bayesian statistics and Conventional statistics, and Kaplan-Meier analysis models; and 3 demonstrates the desired features that should be fulfilled by a well-established ideal patient clinical outcome assessment model. Material & Methods: An integrative review of the literature has been performed using the Google Scholar to explore the field of patient clinical outcome assessment. Conclusion: This paper will directly support researchers, clinicians and health care professionals in their understanding of developments in the domain of the assessment of patient clinical outcome, thus enabling them to propose ideal assessment models.

  11. Instructional Storytelling: Application of the Clinical Judgment Model in Nursing.

    Science.gov (United States)

    Timbrell, Jessica

    2017-05-01

    Little is known about the teaching and learning implications of instructional storytelling (IST) in nursing education or its potential connection to nursing theory. The literature establishes storytelling as a powerful teaching-learning method in the educational, business, humanities, and health sectors, but little exploration exists that is specific to nursing. An example of a story demonstrating application of the domains of Tanner's clinical judgment model links storytelling with learning outcomes appropriate for the novice nursing student. Application of Tanner's clinical judgment model offers consistency of learning experience while preserving the creativity inherent in IST. Further research into student learning outcomes achievement using IST is warranted as a step toward establishing best practices with IST in nursing education. [J Nurs Educ. 2017;56(5):305-308.]. Copyright 2017, SLACK Incorporated.

  12. On model selections for repeated measurement data in clinical studies.

    Science.gov (United States)

    Zou, Baiming; Jin, Bo; Koch, Gary G; Zhou, Haibo; Borst, Stephen E; Menon, Sandeep; Shuster, Jonathan J

    2015-05-10

    Repeated measurement designs have been widely used in various randomized controlled trials for evaluating long-term intervention efficacies. For some clinical trials, the primary research question is how to compare two treatments at a fixed time, using a t-test. Although simple, robust, and convenient, this type of analysis fails to utilize a large amount of collected information. Alternatively, the mixed-effects model is commonly used for repeated measurement data. It models all available data jointly and allows explicit assessment of the overall treatment effects across the entire time spectrum. In this paper, we propose an analytic strategy for longitudinal clinical trial data where the mixed-effects model is coupled with a model selection scheme. The proposed test statistics not only make full use of all available data but also utilize the information from the optimal model deemed for the data. The performance of the proposed method under various setups, including different data missing mechanisms, is evaluated via extensive Monte Carlo simulations. Our numerical results demonstrate that the proposed analytic procedure is more powerful than the t-test when the primary interest is to test for the treatment effect at the last time point. Simulations also reveal that the proposed method outperforms the usual mixed-effects model for testing the overall treatment effects across time. In addition, the proposed framework is more robust and flexible in dealing with missing data compared with several competing methods. The utility of the proposed method is demonstrated by analyzing a clinical trial on the cognitive effect of testosterone in geriatric men with low baseline testosterone levels. Copyright © 2015 John Wiley & Sons, Ltd.

  13. A clinically applicable six-segmented foot model.

    Science.gov (United States)

    De Mits, Sophie; Segers, Veerle; Woodburn, Jim; Elewaut, Dirk; De Clercq, Dirk; Roosen, Philip

    2012-04-01

    We describe a multi-segmented foot model comprising lower leg, rearfoot, midfoot, lateral forefoot, medial forefoot, and hallux for routine use in a clinical setting. The Ghent Foot Model describes the kinematic patterns of functional units of the foot, especially the midfoot, to investigate patient populations where midfoot deformation or dysfunction is an important feature, for example, rheumatoid arthritis patients. Data were obtained from surface markers by a 6 camera motion capture system at 500 Hz. Ten healthy subjects walked barefoot along a 12 m walkway at self-selected speed. Joint angles (rearfoot to shank, midfoot to rearfoot, lateral and medial forefoot to midfoot, and hallux to medial forefoot) in the sagittal, frontal, and transverse plane are reported according to anatomically based reference frames. These angles were calculated and reported during the foot rollover phases in stance, detected by synchronized plantar pressure measurements. Repeated measurements of each subject revealed low intra-subject variability, varying between 0.7° and 2.3° for the minimum values, between 0.5° and 2.1° for the maximum values, and between 0.8° and 5.8° for the ROM. The described movement patterns were repeatable and consistent with biomechanical and clinical knowledge. As such, the Ghent Foot model permits intersegment, in vivo motion measurement of the foot, which is crucial for both clinical and research applications. Copyright © 2011 Orthopaedic Research Society.

  14. Can the ICF osteoarthritis core set represent a future clinical tool in measuring functioning in persons with osteoarthritis undergoing hip and knee joint replacement?

    Science.gov (United States)

    Alviar, Maria Jenelyn; Olver, John; Pallant, Julie F; Brand, Caroline; de Steiger, Richard; Pirpiris, Marinis; Bucknill, Andrew; Khan, Fary

    2012-11-01

    To determine the dimensionality, reliability, model fit, adequacy of the qualifier levels, response patterns across different factors, and targeting of the International Classification of Functioning, Disability and Health (ICF) osteoarthritis core set categories in people with osteoarthritis undergoing hip and knee arthroplasty. The osteoarthritis core set was rated in 316 persons with osteoarthritis who were either in the pre-operative or within one year post-operative stage. Rasch analyses were performed using the RUMM 2030 program. Twelve of the 13 body functions categories and 13 of the 19 activity and participation categories had good model fit. The qualifiers displayed disordered thresholds necessitating rescoring. There was uneven spread of ICF categories across the full range of the patients' scores indicating off--targeting. Subtest analysis of the reduced ICF categories of body functions and activity and participation showed that the two components could be integrated to form one measure. The results suggest that it is possible to measure functioning using a unidimensional construct based on ICF osteoarthritis core set categories of body functions and activity and participation in this population. However, omission of some categories and reduction in qualifier levels are necessary. Further studies are needed to determine whether better targeting is achieved, particularly during the pre-operative and during the sub-acute care period.

  15. Building a semantic web-based metadata repository for facilitating detailed clinical modeling in cancer genome studies.

    Science.gov (United States)

    Sharma, Deepak K; Solbrig, Harold R; Tao, Cui; Weng, Chunhua; Chute, Christopher G; Jiang, Guoqian

    2017-06-05

    Detailed Clinical Models (DCMs) have been regarded as the basis for retaining computable meaning when data are exchanged between heterogeneous computer systems. To better support clinical cancer data capturing and reporting, there is an emerging need to develop informatics solutions for standards-based clinical models in cancer study domains. The objective of the study is to develop and evaluate a cancer genome study metadata management system that serves as a key infrastructure in supporting clinical information modeling in cancer genome study domains. We leveraged a Semantic Web-based metadata repository enhanced with both ISO11179 metadata standard and Clinical Information Modeling Initiative (CIMI) Reference Model. We used the common data elements (CDEs) defined in The Cancer Genome Atlas (TCGA) data dictionary, and extracted the metadata of the CDEs using the NCI Cancer Data Standards Repository (caDSR) CDE dataset rendered in the Resource Description Framework (RDF). The ITEM/ITEM_GROUP pattern defined in the latest CIMI Reference Model is used to represent reusable model elements (mini-Archetypes). We produced a metadata repository with 38 clinical cancer genome study domains, comprising a rich collection of mini-Archetype pattern instances. We performed a case study of the domain "clinical pharmaceutical" in the TCGA data dictionary and demonstrated enriched data elements in the metadata repository are very useful in support of building detailed clinical models. Our informatics approach leveraging Semantic Web technologies provides an effective way to build a CIMI-compliant metadata repository that would facilitate the detailed clinical modeling to support use cases beyond TCGA in clinical cancer study domains.

  16. Representing the effects of alpine grassland vegetation cover on the simulation of soil thermal dynamics by ecosystem models applied to the Qinghai-Tibetan Plateau

    Science.gov (United States)

    Yi, S.; Li, N.; Xiang, B.; Wang, X.; Ye, B.; McGuire, A.D.

    2013-01-01

    Soil surface temperature is a critical boundary condition for the simulation of soil temperature by environmental models. It is influenced by atmospheric and soil conditions and by vegetation cover. In sophisticated land surface models, it is simulated iteratively by solving surface energy budget equations. In ecosystem, permafrost, and hydrology models, the consideration of soil surface temperature is generally simple. In this study, we developed a methodology for representing the effects of vegetation cover and atmospheric factors on the estimation of soil surface temperature for alpine grassland ecosystems on the Qinghai-Tibetan Plateau. Our approach integrated measurements from meteorological stations with simulations from a sophisticated land surface model to develop an equation set for estimating soil surface temperature. After implementing this equation set into an ecosystem model and evaluating the performance of the ecosystem model in simulating soil temperature at different depths in the soil profile, we applied the model to simulate interactions among vegetation cover, freeze-thaw cycles, and soil erosion to demonstrate potential applications made possible through the implementation of the methodology developed in this study. Results showed that (1) to properly estimate daily soil surface temperature, algorithms should use air temperature, downward solar radiation, and vegetation cover as independent variables; (2) the equation set developed in this study performed better than soil surface temperature algorithms used in other models; and (3) the ecosystem model performed well in simulating soil temperature throughout the soil profile using the equation set developed in this study. Our application of the model indicates that the representation in ecosystem models of the effects of vegetation cover on the simulation of soil thermal dynamics has the potential to substantially improve our understanding of the vulnerability of alpine grassland ecosystems to

  17. Pre-Clinical Models of Diffuse Intrinsic Pontine Glioma

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    Oren J Becher

    2015-07-01

    Full Text Available Diffuse Intrinsic Pontine Glioma (DIPG is a rare and incurable brain tumor that arises in the brainstem of children predominantly between the ages of six and eight. Its intricate morphology and involvement of normal pons tissue precludes surgical resection, and the standard of care today remains fractionated radiation alone. In the past 30 years, there have been no significant advances made in the treatment of DIPG. This is largely because we lack good models of DIPG and therefore have little biological basis for treatment. In recent years however, due to increased biopsy and acquisition of autopsy specimens, research is beginning to unravel the genetic and epigenetic drivers of DIPG. Insight gleaned from these studies has led to improvements in approaches to both model these tumors in the lab, as well as to potentially treat them in the clinic. This review will detail the initial strides towards modeling DIPG in animals, which included allograft and xenograft rodent models using non-DIPG glioma cells. Important advances in the field came with the development of in vitro cell and in vivo xenograft models derived directly from autopsy material of DIPG patients or from human embryonic stem cells. Lastly, we will summarize the progress made in the development of genetically engineered mouse models of DIPG. Cooperation of studies incorporating all of these modeling systems to both investigate the unique mechanisms of gliomagenesis in the brainstem and to test potential novel therapeutic agents in a preclinical setting will result in improvement in treatments for DIPG patients.

  18. Testing a theoretical model of clinical nurses' intent to stay.

    Science.gov (United States)

    Cowden, Tracy L; Cummings, Greta G

    2015-01-01

    Published theoretical models of nurses' intent to stay (ITS) report inconsistent outcomes, and not all hypothesized models have been adequately tested. Research has focused on cognitive rather than emotional determinants of nurses' ITS. The aim of this study was to empirically verify a complex theoretical model of nurses' ITS that includes both affective and cognitive determinants and to explore the influence of relational leadership on staff nurses' ITS. The study was a correlational, mixed-method, nonexperimental design. A subsample of the Quality Work Environment Study survey data 2009 (n = 415 nurses) was used to test our theoretical model of clinical nurses' ITS as a structural equation model. The model explained 63% of variance in ITS. Organizational commitment, empowerment, and desire to stay were the model concepts with the strongest effects on nurses' ITS. Leadership practices indirectly influenced ITS. How nurses evaluate and respond to their work environment is both an emotional and rational process. Health care organizations need to be cognizant of the influence that nurses' feelings and views of their work setting have on their intention decisions and integrate that knowledge into the development of retention strategies. Leadership practices play an important role in staff nurses' perceptions of the workplace. Identifying the mechanisms by which leadership influences staff nurses' intentions to stay presents additional focus areas for developing retention strategies.

  19. MERGING conventional and complementary medicine in a clinic department - a theoretical model and practical recommendations.

    Science.gov (United States)

    Pérard, Marion; Mittring, Nadine; Schweiger, David; Kummer, Christopher; Witt, Claudia M

    2015-06-09

    Today, the increasing demand for complementary medicine encourages health care providers to adapt and create integrative medicine departments or services within clinics. However, because of their differing philosophies, historical development, and settings, merging the partners (conventional and complementary medicine) is often difficult. It is necessary to understand the similarities and differences in both cultures to support a successful and sustainable integration. The aim of this project was to develop a theoretical model and practical steps that are based on theories from mergers in business to facilitate the implementation of an integrative medicine department. Based on a literature search and expert discussions, the cultures were described and model domains were developed. These were applied to two case studies to develop the final model. Furthermore, a checklist with practical steps was devised. Conventional medicine and complementary medicine have developed different corporate cultures. The final model, which should help to foster integration by bridging between these cultures, is based on four overall aspects: culture, strategy, organizational tools and outcomes. Each culture is represented by three dimensions in the model: corporate philosophy (core and identity of the medicine and the clinic), patient (all characteristics of the professional team's contact with the patient), and professional team (the characteristics of the interactions within the professional team). Overall, corporate culture differs between conventional and complementary medicine; when planning the implementation of an integrative medicine department, the developed model and the checklist can support better integration.

  20. Impact of Representing Model Error in a Hybrid Ensemble-Variational Data Assimilation System for Track Forecast of Tropical Cyclones over the Bay of Bengal

    Science.gov (United States)

    Kutty, Govindan; Muraleedharan, Rohit; Kesarkar, Amit P.

    2018-03-01

    Uncertainties in the numerical weather prediction models are generally not well-represented in ensemble-based data assimilation (DA) systems. The performance of an ensemble-based DA system becomes suboptimal, if the sources of error are undersampled in the forecast system. The present study examines the effect of accounting for model error treatments in the hybrid ensemble transform Kalman filter—three-dimensional variational (3DVAR) DA system (hybrid) in the track forecast of two tropical cyclones viz. Hudhud and Thane, formed over the Bay of Bengal, using Advanced Research Weather Research and Forecasting (ARW-WRF) model. We investigated the effect of two types of model error treatment schemes and their combination on the hybrid DA system; (i) multiphysics approach, which uses different combination of cumulus, microphysics and planetary boundary layer schemes, (ii) stochastic kinetic energy backscatter (SKEB) scheme, which perturbs the horizontal wind and potential temperature tendencies, (iii) a combination of both multiphysics and SKEB scheme. Substantial improvements are noticed in the track positions of both the cyclones, when flow-dependent ensemble covariance is used in 3DVAR framework. Explicit model error representation is found to be beneficial in treating the underdispersive ensembles. Among the model error schemes used in this study, a combination of multiphysics and SKEB schemes has outperformed the other two schemes with improved track forecast for both the tropical cyclones.

  1. A Computational Model Based on Multi-Regional Calcium Imaging Represents the Spatio-Temporal Dynamics in a Caenorhabditis elegans Sensory Neuron.

    Directory of Open Access Journals (Sweden)

    Masahiro Kuramochi

    Full Text Available Due to the huge number of neuronal cells in the brain and their complex circuit formation, computer simulation of neuronal activity is indispensable to understanding whole brain dynamics. Recently, various computational models have been developed based on whole-brain calcium imaging data. However, these analyses monitor only the activity of neuronal cell bodies and treat the cells as point unit. This point-neuron model is inexpensive in computational costs, but the model is unrealistically simplistic at representing intact neural activities in the brain. Here, we describe a novel three-unit Ordinary Differential Equation (ODE model based on the neuronal responses derived from a Caenorhabditis elegans salt-sensing neuron. We recorded calcium responses in three regions of the ASER neuron using a simple downstep of NaCl concentration. Our simple ODE model generated from a single recording can adequately reproduce and predict the temporal responses of each part of the neuron to various types of NaCl concentration changes. Our strategy which combines a simple recording data and an ODE mathematical model may be extended to realistically understand whole brain dynamics by computational simulation.

  2. Animal models of chronic wound care: the application of biofilms in clinical research

    Directory of Open Access Journals (Sweden)

    Trøstrup H

    2016-11-01

    Full Text Available Hannah Trøstrup,1 Kim Thomsen,1 Henrik Calum,2 Niels Høiby,1,3 Claus Moser1 1Department of Clinical Microbiology, Copenhagen University Hospital, Rigshospitalet, 2Department of Clinical Microbiology, Copenhagen University Hospital, Hvidovre, 3Institute for Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark Abstract: Chronic wounds are a substantial clinical problem affecting millions of people worldwide. Pathophysiologically, chronic wounds are stuck in the inflammatory state of healing. The role of bacterial biofilms in suppression and perturbation of host response could be an explanation for this observation. An inhibiting effect of bacterial biofilms on wound healing is gaining significant clinical attention over the last few years. There is still a paucity of suitable animal models to recapitulate human chronic wounds. The etiology of the wound (venous insufficiency, ischemia, diabetes, pressure has to be taken into consideration as underlying pathophysiological mechanisms and comorbidities display tremendous variation in humans. Confounders such as infection, smoking, chronological age, sex, medication, metabolic disturbances, and renal impairment add to the difficulty in gaining systematic and comparable studies on nonhealing wounds. Relevant hypotheses based on clinical or in vitro observations can be tested in representative animal models, which provide crucial tools to uncover the pathophysiology of cutaneous skin repair in infectious environments. Disposing factors, species of the infectious agent(s, and time of establishment of the infection are well defined in suitable animal models. In addition, several endpoints can be involved for evaluation. Animals do not display chronic wounds in the way that humans do. However, in many cases, animal models can mirror the pathological conditions observed in humans, although discrepancies between human and animal wound repair are obvious. The use of animal models should

  3. Clinical information modeling processes for semantic interoperability of electronic health records: systematic review and inductive analysis.

    Science.gov (United States)

    Moreno-Conde, Alberto; Moner, David; Cruz, Wellington Dimas da; Santos, Marcelo R; Maldonado, José Alberto; Robles, Montserrat; Kalra, Dipak

    2015-07-01

    This systematic review aims to identify and compare the existing processes and methodologies that have been published in the literature for defining clinical information models (CIMs) that support the semantic interoperability of electronic health record (EHR) systems. Following the preferred reporting items for systematic reviews and meta-analyses systematic review methodology, the authors reviewed published papers between 2000 and 2013 that covered that semantic interoperability of EHRs, found by searching the PubMed, IEEE Xplore, and ScienceDirect databases. Additionally, after selection of a final group of articles, an inductive content analysis was done to summarize the steps and methodologies followed in order to build CIMs described in those articles. Three hundred and seventy-eight articles were screened and thirty six were selected for full review. The articles selected for full review were analyzed to extract relevant information for the analysis and characterized according to the steps the authors had followed for clinical information modeling. Most of the reviewed papers lack a detailed description of the modeling methodologies used to create CIMs. A representative example is the lack of description related to the definition of terminology bindings and the publication of the generated models. However, this systematic review confirms that most clinical information modeling activities follow very similar steps for the definition of CIMs. Having a robust and shared methodology could improve their correctness, reliability, and quality. Independently of implementation technologies and standards, it is possible to find common patterns in methods for developing CIMs, suggesting the viability of defining a unified good practice methodology to be used by any clinical information modeler. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. CDC25A Protein Stability Represents a Previously Unrecognized Target of HER2 Signaling in Human Breast Cancer: Implication for a Potential Clinical Relevance in Trastuzumab Treatment

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    Emanuela Brunetto

    2013-06-01

    Full Text Available The CDC25A-CDK2 pathway has been proposed as critical for the oncogenic action of human epidermal growth factor receptor 2 (HER2 in mammary epithelial cells. In particular, transgenic expression of CDC25A cooperates with HER2 in promoting mammary tumors, whereas CDC25A hemizygous loss attenuates the HER2-induced tumorigenesis penetrance. On the basis of this evidence of a synergism between HER2 and the cell cycle regulator CDC25A in a mouse model of mammary tumorigenesis, we investigated the role of CDC25A in human HER2-positive breast cancer and its possible implications in therapeutic response. HER2 status and CDC25A expression were assessed in 313 breast cancer patients and we found statistically significant correlation between HER2 and CDC25A (P = .007. Moreover, an HER2-positive breast cancer subgroup with high levels of CDC25A and very aggressive phenotype was identified (P = .005. Importantly, our in vitro studies on breast cancer cell lines showed that the HER2 inhibitor efficacy on cell growth and viability relied also on CDC25A expression and that such inhibition induces CDC25A down-regulation through phosphatidylinositol 3-kinase/protein kinase B pathway and DNA damage response activation. In line with this observation, we found a statistical significant association between CDC25A overexpression and trastuzumab-combined therapy response rate in two different HER2-positive cohorts of trastuzumab-treated patients in either metastatic or neoadjuvant setting (P = .018 for the metastatic cohort and P = .021 for the neoadjuvant cohort. Our findings highlight a link between HER2 and CDC25A that positively modulates HER2- targeted therapy response, suggesting that, in HER2-positive breast cancer patients, CDC25A overexpression affects trastuzumab sensitivity.

  5. Clinical application of the five-factor model.

    Science.gov (United States)

    Widiger, Thomas A; Presnall, Jennifer Ruth

    2013-12-01

    The Five-Factor Model (FFM) has become the predominant dimensional model of general personality structure. The purpose of this paper is to suggest a clinical application. A substantial body of research indicates that the personality disorders included within the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) can be understood as extreme and/or maladaptive variants of the FFM (the acronym "DSM" refers to any particular edition of the APA DSM). In addition, the current proposal for the forthcoming fifth edition of the DSM (i.e., DSM-5) is shifting closely toward an FFM dimensional trait model of personality disorder. Advantages of this shifting conceptualization are discussed, including treatment planning. © 2012 Wiley Periodicals, Inc.

  6. Models for Clinical Education Accompanying in Mental Health and Psychiatry

    Directory of Open Access Journals (Sweden)

    Lino Ramos

    2017-08-01

    Full Text Available Objective: To analyze the available scientific literature on the follow-up models in Clinical Teaching in Mental Health, carrying out a systematic review of the literature with re- search in the electronic databases PubMed, B-On, EBSCO platform and Scielo, as well as the Open Access scientific repositories of Portugal. Methodology: The present work consists of a systematic literature review (RSL. Keyword databases were searched first, the results were filtered according to exclusion and inclusion criteria and only selected the most appropriate references to answer the research question that were subsequently submitted to an evaluation by CASPe. The final sample includes 11 articles. Results: In the last decades, the training of nursing students has been the subject of several changes and transformations, once it is agreed that the training takes place in moments of theoretical training and moments of practical training in clinical teaching. Clinical teaching is a privileged space for the learning of nursing students. This is where they have the possibility to develop and mobilize skills and build knowledge The orientation of nursing students in clinical education has been the subject of numerous investigations in recent years; the area of Mental Health and Psychiatry (MHP shows a significant role in the development and construction of the identity of the nursing professional future. in the follow-up of students in clinical teaching, several actors stand out: the student, the teacher and the nurse orientate, who take special importance in the process of personal and professional development of the student, having a pedagogical, social and professional responsibility. The provision of care in MHP Clinical Teaching requires a wide range that allows the student to develop several aspects, namely creativity, therapeutic communication, sensitivity to care, listening, empathy, and interpersonal relationship capacity with the person, multi- disciplinary

  7. SU-F-T-276: Source Modeling and VMAT Quality Assurance Referring to the TrueBeam Representative Beam Data for Eclipse

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Q [Beijing Hospital, Beijing (China)

    2016-06-15

    Purpose: To study quality assurance (QA) of volumetric modulated arc therapy (VMAT) after the 6MV and 10MV photon beam source modeling, referring to the Varian TrueBeam representative beam data for Eclipse. Methods: The source model needs specific measured beam data, such as PDDs and profiles, diagonal profile, output factors (OFs), and MLC transmission factor (TF) and dosimetric leaf gap (DLG), et al. We downloaded the representative data from myVarian website, which includes TrueBeam 4MV-15MV photon beam data and 6MeV-22MeV electron beam data in w2CAD file format for use with Eclipse and in Excel spreadsheet format for use in data comparison. The beam data in W2CAD format can be imported into the Eclipse system and calibrated for use, as appropriate. We used PTW MP3 water tank to measure the beam data in some typical field sizes, and compared the measured data with the representative data. We found that the PDDs, profiles and OFs are similar. However according to some papers and our measurements, we decided that our MLC TF and DLG are 1.58 and 1.33 (6MV), 1.79 and 1.57 (10MV), respectively. After we had configured the anisotropic analytical algorithm (AAA) with the representative data in Eclipse, we also have done dosimetric verification for 88 VMAT plans. Results: The end-to-end test procedures of VMAT were performed for 6MV and 10MV energy modes. The NE Farmer ion chamber mean measurements showed 1.2% (6MV, 38 cases) and 1.2% (10MV, 50 cases) between measurement and calculation; the Sun Nuclear ArcCheck mean measurements demonstrated gamma pass rates are as followings: 98.9%, 93.2%, 61.0% for 6MV, and 98.9%, 91.9%, 59.5% for 10MV, using 3%/3mm, 2%/2mm, 1%/1mm, 10% threshold criteria, respectively. Conclusion: The representative data is applicable to our TrueBeam for the VMAT plan, though our MLC factors are a little different, and its patientspecific QA is good.

  8. Knowledgeable Neighbors: a mobile clinic model for disease prevention and screening in underserved communities.

    Science.gov (United States)

    Hill, Caterina; Zurakowski, David; Bennet, Jennifer; Walker-White, Rainelle; Osman, Jamie L; Quarles, Aaron; Oriol, Nancy

    2012-03-01

    The Family Van mobile health clinic uses a "Knowledgeable Neighbor" model to deliver cost-effective screening and prevention activities in underserved neighborhoods in Boston, MA. We have described the Knowledgeable Neighbor model and used operational data collected from 2006 to 2009 to evaluate the service. The Family Van successfully reached mainly minority low-income men and women. Of the clients screened, 60% had previously undetected elevated blood pressure, 14% had previously undetected elevated blood glucose, and 38% had previously undetected elevated total cholesterol. This represents an important model for reaching underserved communities to deliver proven cost-effective prevention activities, both to help control health care costs and to reduce health disparities.

  9. Using prognostic models in CLL to personalize approach to clinical care: Are we there yet?

    Science.gov (United States)

    Mina, Alain; Sandoval Sus, Jose; Sleiman, Elsa; Pinilla-Ibarz, Javier; Awan, Farrukh T; Kharfan-Dabaja, Mohamed A

    2018-03-01

    Four decades ago, two staging systems were developed to help stratify CLL into different prognostic categories. These systems, the Rai and the Binet staging, depended entirely on abnormal exam findings and evidence of anemia and thrombocytopenia. Better understanding of biologic, genetic, and molecular characteristics of CLL have contributed to better appreciating its clinical heterogeneity. New prognostic models, the GCLLSG prognostic index and the CLL-IPI, emerged. They incorporate biologic and genetic information related to CLL and are capable of predicting survival outcomes and cases anticipated to need therapy earlier in the disease course. Accordingly, these newer models are helping develop better informed surveillance strategies and ultimately tailor treatment intensity according to presence (or lack thereof) of certain prognostic markers. This represents a step towards personalizing care of CLL patients. We anticipate that as more prognostic factors continue to be identified, the GCLLSG prognostic index and CLL-IPI models will undergo further revisions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Beyond clinical engagement: a pragmatic model for quality improvement interventions, aligning clinical and managerial priorities.

    Science.gov (United States)

    Pannick, Samuel; Sevdalis, Nick; Athanasiou, Thanos

    2016-09-01

    Despite taking advantage of established learning from other industries, quality improvement initiatives in healthcare may struggle to outperform secular trends. The reasons for this are rarely explored in detail, and are often attributed merely to difficulties in engaging clinicians in quality improvement work. In a narrative review of the literature, we argue that this focus on clinicians, at the relative expense of managerial staff, has proven counterproductive. Clinical engagement is not a universal challenge; moreover, there is evidence that managers-particularly middle managers-also have a role to play in quality improvement. Yet managerial participation in quality improvement interventions is often assumed, rather than proven. We identify specific factors that influence the coordination of front-line staff and managers in quality improvement, and integrate these factors into a novel model: the model of alignment. We use this model to explore the implementation of an interdisciplinary intervention in a recent trial, describing different participation incentives and barriers for different staff groups. The extent to which clinical and managerial interests align may be an important determinant of the ultimate success of quality improvement interventions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  11. Using physiologically based models for clinical translation: predictive modelling, data interpretation or something in-between?

    Science.gov (United States)

    Niederer, Steven A; Smith, Nic P

    2016-12-01

    Heart disease continues to be a significant clinical problem in Western society. Predictive models and simulations that integrate physiological understanding with patient information derived from clinical data have huge potential to contribute to improving our understanding of both the progression and treatment of heart disease. In particular they provide the potential to improve patient selection and optimisation of cardiovascular interventions across a range of pathologies. Currently a significant proportion of this potential is still to be realised. In this paper we discuss the opportunities and challenges associated with this realisation. Reviewing the successful elements of model translation for biophysically based models and the emerging supporting technologies, we propose three distinct modes of clinical translation. Finally we outline the challenges ahead that will be fundamental to overcome if the ultimate goal of fully personalised clinical cardiac care is to be achieved. © 2016 The Authors. The Journal of Physiology © 2016 The Physiological Society.

  12. The Union Health Center: a working model of clinical care linked to preventive occupational health services.

    Science.gov (United States)

    Herbert, R; Plattus, B; Kellogg, L; Luo, J; Marcus, M; Mascolo, A; Landrigan, P J

    1997-03-01

    of this approach, index cases of rotator cuff tendonitis, lead poisoning, and formaldehyde overexposure in three patients and their preventative workplace follow-up, affecting approximately 150 workers at three worksites, are described. Work-related conditions diagnosed during the first 3 years of clinic operation included cumulative trauma disorders (141 cases), carpal tunnel syndrome (47 cases), low back disorders (33 cases), lead poisoning (20 cases), and respiratory disease (9 cases). This pilot project represents a new model for effective integration of clinical care and occupational disease prevention efforts within a primary care center. It could serve as a prototype for development of such services in other managed and primary care settings.

  13. Improving the quality of clinical coding: a comprehensive audit model

    Directory of Open Access Journals (Sweden)

    Hamid Moghaddasi

    2014-04-01

    Full Text Available Introduction: The review of medical records with the aim of assessing the quality of codes has long been conducted in different countries. Auditing medical coding, as an instructive approach, could help to review the quality of codes objectively using defined attributes, and this in turn would lead to improvement of the quality of codes. Method: The current study aimed to present a model for auditing the quality of clinical codes. The audit model was formed after reviewing other audit models, considering their strengths and weaknesses. A clear definition was presented for each quality attribute and more detailed criteria were then set for assessing the quality of codes. Results: The audit tool (based on the quality attributes included legibility, relevancy, completeness, accuracy, definition and timeliness; led to development of an audit model for assessing the quality of medical coding. Delphi technique was then used to reassure the validity of the model. Conclusion: The inclusive audit model designed could provide a reliable and valid basis for assessing the quality of codes considering more quality attributes and their clear definition. The inter-observer check suggested in the method of auditing is of particular importance to reassure the reliability of coding.

  14. Clinical Herpes Zoster in Antarctica as a Model for Spaceflight.

    Science.gov (United States)

    Reyes, David P; Brinley, Alaina A; Blue, Rebecca S; Gruschkus, Stephen K; Allen, Andrew T; Parazynski, Scott E

    2017-08-01

    Antarctica is a useful analog for spaceflight, as both environments are remote, isolated, and with limited resources. While previous studies have demonstrated increased asymptomatic viral shedding in both the Antarctic and spaceflight environments, clinical manifestations of reactivated viral disease have been less frequently identified. We sought to identify the incidence of clinical herpes zoster from viral reactivation in the Antarctic winter-over population. Medical records from the 2014 winter season were reviewed for the incidence of zoster in U.S. Antarctic personnel and then compared to the age-matched U.S. Five cases of clinical herpes zoster occurred in the Antarctic Station population of 204 persons, for an incidence of 33.3 per 1000 person-years vs. 3.2 per 1000 person-years in the general population. Four cases were in persons under age 40, yielding an incidence of 106.7 per 1000 person-years in persons ages 30-39 compared to an incidence of 2.0 per 1000 person-years in the same U.S. age group. Immune suppression due to the stressful Antarctic environment may have contributed to the increased incidence of herpes zoster in U.S. Antarctic personnel during the winter of 2014. Working and living in isolated, confined, and extreme environments can cause immune suppression, reactivating latent viruses and increasing viral shedding and symptomatic disease. Such changes have been observed in other austere environments, including spaceflight, suggesting that clinical manifestations of viral reactivation may be seen in future spaceflight.Reyes DP, Brinley AA, Blue RS, Gruschkus SK, Allen AT, Parazynski SE. Clinical herpes zoster in Antarctica as a model for spaceflight. Aerosp Med Hum Perform. 2017; 88(8):784-788.

  15. Representing anthropogenic gross land use change, wood harvest, and forest age dynamics in a global vegetation model ORCHIDEE-MICT v8.4.2

    Science.gov (United States)

    Yue, Chao; Ciais, Philippe; Luyssaert, Sebastiaan; Li, Wei; McGrath, Matthew J.; Chang, Jinfeng; Peng, Shushi

    2018-01-01

    Land use change (LUC) is among the main anthropogenic disturbances in the global carbon cycle. Here we present the model developments in a global dynamic vegetation model ORCHIDEE-MICT v8.4.2 for a more realistic representation of LUC processes. First, we included gross land use change (primarily shifting cultivation) and forest wood harvest in addition to net land use change. Second, we included sub-grid evenly aged land cohorts to represent secondary forests and to keep track of the transient stage of agricultural lands since LUC. Combination of these two features allows the simulation of shifting cultivation with a rotation length involving mainly secondary forests instead of primary ones. Furthermore, a set of decision rules regarding the land cohorts to be targeted in different LUC processes have been implemented. Idealized site-scale simulation has been performed for miombo woodlands in southern Africa assuming an annual land turnover rate of 5 % grid cell area between forest and cropland. The result shows that the model can correctly represent forest recovery and cohort aging arising from agricultural abandonment. Such a land turnover process, even though without a net change in land cover, yields carbon emissions largely due to the imbalance between the fast release from forest clearing and the slow uptake from agricultural abandonment. The simulation with sub-grid land cohorts gives lower emissions than without, mainly because the cleared secondary forests have a lower biomass carbon stock than the mature forests that are otherwise cleared when sub-grid land cohorts are not considered. Over the region of southern Africa, the model is able to account for changes in different forest cohort areas along with the historical changes in different LUC activities, including regrowth of old forests when LUC area decreases. Our developments provide possibilities to account for continental or global forest demographic change resulting from past anthropogenic and

  16. Models for patients' recruitment in clinical trials and sensitivity analysis.

    Science.gov (United States)

    Mijoule, Guillaume; Savy, Stéphanie; Savy, Nicolas

    2012-07-20

    Taking a decision on the feasibility and estimating the duration of patients' recruitment in a clinical trial are very important but very hard questions to answer, mainly because of the huge variability of the system. The more elaborated works on this topic are those of Anisimov and co-authors, where they investigate modelling of the enrolment period by using Gamma-Poisson processes, which allows to develop statistical tools that can help the manager of the clinical trial to answer these questions and thus help him to plan the trial. The main idea is to consider an ongoing study at an intermediate time, denoted t(1). Data collected on [0,t(1)] allow to calibrate the parameters of the model, which are then used to make predictions on what will happen after t(1). This method allows us to estimate the probability of ending the trial on time and give possible corrective actions to the trial manager especially regarding how many centres have to be open to finish on time. In this paper, we investigate a Pareto-Poisson model, which we compare with the Gamma-Poisson one. We will discuss the accuracy of the estimation of the parameters and compare the models on a set of real case data. We make the comparison on various criteria : the expected recruitment duration, the quality of fitting to the data and its sensitivity to parameter errors. We discuss the influence of the centres opening dates on the estimation of the duration. This is a very important question to deal with in the setting of our data set. In fact, these dates are not known. For this discussion, we consider a uniformly distributed approach. Finally, we study the sensitivity of the expected duration of the trial with respect to the parameters of the model : we calculate to what extent an error on the estimation of the parameters generates an error in the prediction of the duration.

  17. [Clinical ethics consultation - an integrative model for practice and reflection].

    Science.gov (United States)

    Reiter-Theil, Stella

    2008-07-01

    Broad evidence exists that health care professionals are facing ethical difficulties in patient care demanding a spectrum of useful ethics support services. Clinical ethics consultation is one of these forms of ethics support being effective in the acute setting. An authentic case is presented as an illustration. We introduce an integrative model covering the activities being characteristic for ethics consultation and going beyond "school"-specific approaches. Finally, we formulate some do's and don'ts of ethics consultation that are considered to be key issues for successful practice.

  18. Task Analytic Models to Guide Analysis and Design: Use of the Operator Function Model to Represent Pilot-Autoflight System Mode Problems

    Science.gov (United States)

    Degani, Asaf; Mitchell, Christine M.; Chappell, Alan R.; Shafto, Mike (Technical Monitor)

    1995-01-01

    Task-analytic models structure essential information about operator interaction with complex systems, in this case pilot interaction with the autoflight system. Such models serve two purposes: (1) they allow researchers and practitioners to understand pilots' actions; and (2) they provide a compact, computational representation needed to design 'intelligent' aids, e.g., displays, assistants, and training systems. This paper demonstrates the use of the operator function model to trace the process of mode engagements while a pilot is controlling an aircraft via the, autoflight system. The operator function model is a normative and nondeterministic model of how a well-trained, well-motivated operator manages multiple concurrent activities for effective real-time control. For each function, the model links the pilot's actions with the required information. Using the operator function model, this paper describes several mode engagement scenarios. These scenarios were observed and documented during a field study that focused on mode engagements and mode transitions during normal line operations. Data including time, ATC clearances, altitude, system states, and active modes and sub-modes, engagement of modes, were recorded during sixty-six flights. Using these data, seven prototypical mode engagement scenarios were extracted. One scenario details the decision of the crew to disengage a fully automatic mode in favor of a semi-automatic mode, and the consequences of this action. Another describes a mode error involving updating aircraft speed following the engagement of a speed submode. Other scenarios detail mode confusion at various phases of the flight. This analysis uses the operator function model to identify three aspects of mode engagement: (1) the progress of pilot-aircraft-autoflight system interaction; (2) control/display information required to perform mode management activities; and (3) the potential cause(s) of mode confusion. The goal of this paper is twofold

  19. Beyond discrimination: A comparison of calibration methods and clinical usefulness of predictive models of readmission risk.

    Science.gov (United States)

    Walsh, Colin G; Sharman, Kavya; Hripcsak, George

    2017-12-01

    Prior to implementing predictive models in novel settings, analyses of calibration and clinical usefulness remain as important as discrimination, but they are not frequently discussed. Calibration is a model's reflection of actual outcome prevalence in its predictions. Clinical usefulness refers to the utilities, costs, and harms of using a predictive model in practice. A decision analytic approach to calibrating and selecting an optimal intervention threshold may help maximize the impact of readmission risk and other preventive interventions. To select a pragmatic means of calibrating predictive models that requires a minimum amount of validation data and that performs well in practice. To evaluate the impact of miscalibration on utility and cost via clinical usefulness analyses. Observational, retrospective cohort study with electronic health record data from 120,000 inpatient admissions at an urban, academic center in Manhattan. The primary outcome was thirty-day readmission for three causes: all-cause, congestive heart failure, and chronic coronary atherosclerotic disease. Predictive modeling was performed via L1-regularized logistic regression. Calibration methods were compared including Platt Scaling, Logistic Calibration, and Prevalence Adjustment. Performance of predictive modeling and calibration was assessed via discrimination (c-statistic), calibration (Spiegelhalter Z-statistic, Root Mean Square Error [RMSE] of binned predictions, Sanders and Murphy Resolutions of the Brier Score, Calibration Slope and Intercept), and clinical usefulness (utility terms represented as costs). The amount of validation data necessary to apply each calibration algorithm was also assessed. C-statistics by diagnosis ranged from 0.7 for all-cause readmission to 0.86 (0.78-0.93) for congestive heart failure. Logistic Calibration and Platt Scaling performed best and this difference required analyzing multiple metrics of calibration simultaneously, in particular Calibration

  20. A conceptual model for translating omic data into clinical action

    Directory of Open Access Journals (Sweden)

    Timothy M Herr

    2015-01-01

    Full Text Available Genomic, proteomic, epigenomic, and other "omic" data have the potential to enable precision medicine, also commonly referred to as personalized medicine. The volume and complexity of omic data are rapidly overwhelming human cognitive capacity, requiring innovative approaches to translate such data into patient care. Here, we outline a conceptual model for the application of omic data in the clinical context, called "the omic funnel." This model parallels the classic "Data, Information, Knowledge, Wisdom pyramid" and adds context for how to move between each successive layer. Its goal is to allow informaticians, researchers, and clinicians to approach the problem of translating omic data from bench to bedside, by using discrete steps with clearly defined needs. Such an approach can facilitate the development of modular and interoperable software that can bring precision medicine into widespread practice.

  1. Towards a traceable clinical guidelines application. A model-driven approach.

    Science.gov (United States)

    Domínguez, E; Pérez, B; Zapata, M

    2010-01-01

    The goal of this research is to provide an overall framework to enable model-based development of clinical guideline-based decision support systems (GBDSSs). The automatically generated GBDSSs are aimed at providing guided support to the physician during the application of guidelines and automatically storing guideline application data for traceability purposes. The development process of a GBDSS for a guideline is based on model-driven development (MDD) techniques which allow us to carry out such a process automatically, making development more agile and saving on human resource costs. We use UML Statecharts to represent the dynamics of guidelines and, based on this model, we use a MDD-based tool chain to generate the guideline-dependent components of each GBDSS in an automatic way. In particular, as for the traceability capabilities of each GBDSS, MDD techniques are combined with database schema mappings for metadata management in order to automatically generate the GBDSS-persistent component as one of the main contributions of this paper. The complete framework has been implemented as an Eclipse plug-in named GBDSSGenerator which, starting from the statechart representing a guideline, allows the development process to be carried out automatically by only selecting different menu options the plug-in provides. We have successfully validated our overall approach by generating the GBDSS for different types of clinical guidelines, even for laboratory guidelines. The proposed framework allows the development of clinical guideline-based decision support systems in an automatic way making this process more agile and saving on human resource costs.

  2. The use of artificial neural network modeling to represent the process of concentration by molecular distillation of omega-3 from squid oil

    Directory of Open Access Journals (Sweden)

    Rossi, P.

    2014-12-01

    Full Text Available The concentration of omega-3 compounds obtained for the esterification of squid oil by molecular distillation was carried out in two stages. This operation can process these thermolabile and high molecular weight components at very low temperatures. Given the mathematical complexity of the theoretical model, artificial neural networks (ANN have provided an alternative to a classical computing analysis. The objective of this study was to create a predictive model using artificial neural network techniques to represent the concentration process of omega-3 compounds obtained from squid oil using molecular distillation. Another objective of this study was to analyze the performance of two different alternatives of ANN modeling; one of them is a model that represents all variables in the process and the other is a global model that simulates only the input and output variables of the process. The alternative of the ANN global model showed the best fit to the experimental data.La concentración de compuestos omega-3, obtenidos de la esterificación de aceite de calamar, por destilación molecular fue llevada a cabo en dos etapas. Esta operación permite procesar componentes termolábiles y de alto peso molecular a muy bajas temperaturas. Dada la alta complejidad de los modelos teóricos, las redes neuronales artificiales (RNA conforman una alternativa al análisis computacional clásico. El objetivo de este estudio fue crear un modelo predictivo usando modelos de redes neuronales artificiales para representar el proceso de concentración de compuestos omega-3 obtenidos del aceite de calamar por destilación molecular. Otro objetivo de este estudio fue analizar el desenvolvimiento de dos alternativas de modelos RNA; uno de ellos es un modelo que representa todas las variables en el proceso y otro es un modelo global que simula solo las variables de entrada y de salida del proceso. La alternativa de un modelo RNA global mostró el mejor ajuste de los

  3. Automatic generation of computable implementation guides from clinical information models.

    Science.gov (United States)

    Boscá, Diego; Maldonado, José Alberto; Moner, David; Robles, Montserrat

    2015-06-01

    Clinical information models are increasingly used to describe the contents of Electronic Health Records. Implementation guides are a common specification mechanism used to define such models. They contain, among other reference materials, all the constraints and rules that clinical information must obey. However, these implementation guides typically are oriented to human-readability, and thus cannot be processed by computers. As a consequence, they must be reinterpreted and transformed manually into an executable language such as Schematron or Object Constraint Language (OCL). This task can be difficult and error prone due to the big gap between both representations. The challenge is to develop a methodology for the specification of implementation guides in such a way that humans can read and understand easily and at the same time can be processed by computers. In this paper, we propose and describe a novel methodology that uses archetypes as basis for generation of implementation guides. We use archetypes to generate formal rules expressed in Natural Rule Language (NRL) and other reference materials usually included in implementation guides such as sample XML instances. We also generate Schematron rules from NRL rules to be used for the validation of data instances. We have implemented these methods in LinkEHR, an archetype editing platform, and exemplify our approach by generating NRL rules and implementation guides from EN ISO 13606, openEHR, and HL7 CDA archetypes. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Modeling the clinical and economic implications of obesity using microsimulation.

    Science.gov (United States)

    Su, W; Huang, J; Chen, F; Iacobucci, W; Mocarski, M; Dall, T M; Perreault, L

    2015-01-01

    The obesity epidemic has raised considerable public health concerns, but there are few validated longitudinal simulation models examining the human and economic cost of obesity. This paper describes a microsimulation model as a comprehensive tool to understand the relationship between body weight, health, and economic outcomes. Patient health and economic outcomes were simulated annually over 10 years using a Markov-based microsimulation model. The obese population examined is nationally representative of obese adults in the US from the 2005-2012 National Health and Nutrition Examination Surveys, while a matched normal weight population was constructed to have similar demographics as the obese population during the same period. Prediction equations for onset of obesity-related comorbidities, medical expenditures, economic outcomes, mortality, and quality-of-life came from published trials and studies supplemented with original research. Model validation followed International Society for Pharmacoeconomics and Outcomes Research practice guidelines. Among surviving adults, relative to a matched normal weight population, obese adults averaged $3900 higher medical expenditures in the initial year, growing to $4600 higher expenditures in year 10. Obese adults had higher initial prevalence and higher simulated onset of comorbidities as they aged. Over 10 years, excess medical expenditures attributed to obesity averaged $4280 annually-ranging from $2820 for obese category I to $5100 for obese category II, and $8710 for obese category III. Each excess kilogram of weight contributed to $140 higher annual costs, on average, ranging from $136 (obese I) to $152 (obese III). Poor health associated with obesity increased work absenteeism and mortality, and lowered employment probability, personal income, and quality-of-life. This validated model helps illustrate why obese adults have higher medical and indirect costs relative to normal weight adults, and shows that medical costs

  5. Mathematical modeling of human glioma growth based on brain topological structures: study of two clinical cases.

    Directory of Open Access Journals (Sweden)

    Cecilia Suarez

    Full Text Available Gliomas are the most common primary brain tumors and yet almost incurable due mainly to their great invasion capability. This represents a challenge to present clinical oncology. Here, we introduce a mathematical model aiming to improve tumor spreading capability definition. The model consists in a time dependent reaction-diffusion equation in a three-dimensional spatial domain that distinguishes between different brain topological structures. The model uses a series of digitized images from brain slices covering the whole human brain. The Talairach atlas included in the model describes brain structures at different levels. Also, the inclusion of the Brodmann areas allows prediction of the brain functions affected during tumor evolution and the estimation of correlated symptoms. The model is solved numerically using patient-specific parametrization and finite differences. Simulations consider an initial state with cellular proliferation alone (benign tumor, and an advanced state when infiltration starts (malign tumor. Survival time is estimated on the basis of tumor size and location. The model is used to predict tumor evolution in two clinical cases. In the first case, predictions show that real infiltrative areas are underestimated by current diagnostic imaging. In the second case, tumor spreading predictions were shown to be more accurate than those derived from previous models in the literature. Our results suggest that the inclusion of differential migration in glioma growth models constitutes another step towards a better prediction of tumor infiltration at the moment of surgical or radiosurgical target definition. Also, the addition of physiological/psychological considerations to classical anatomical models will provide a better and integral understanding of the patient disease at the moment of deciding therapeutic options, taking into account not only survival but also life quality.

  6. The Jena Diversity-Dynamic Global Vegetation Model (JeDi-DGVM: a diverse approach to representing terrestrial biogeography and biogeochemistry based on plant functional trade-offs

    Directory of Open Access Journals (Sweden)

    R. Pavlick

    2013-06-01

    Full Text Available Terrestrial biosphere models typically abstract the immense diversity of vegetation forms and functioning into a relatively small set of predefined semi-empirical plant functional types (PFTs. There is growing evidence, however, from the field ecology community as well as from modelling studies that current PFT schemes may not adequately represent the observed variations in plant functional traits and their effect on ecosystem functioning. In this paper, we introduce the Jena Diversity-Dynamic Global Vegetation Model (JeDi-DGVM as a new approach to terrestrial biosphere modelling with a richer representation of functional diversity than traditional modelling approaches based on a small number of fixed PFTs. JeDi-DGVM simulates the performance of a large number of randomly generated plant growth strategies, each defined by a set of 15 trait parameters which characterize various aspects of plant functioning including carbon allocation, ecophysiology and phenology. Each trait parameter is involved in one or more functional trade-offs. These trade-offs ultimately determine whether a strategy is able to survive under the climatic conditions in a given model grid cell and its performance relative to the other strategies. The biogeochemical fluxes and land surface properties of the individual strategies are aggregated to the grid-cell scale using a mass-based weighting scheme. We evaluate the simulated global biogeochemical patterns against a variety of field and satellite-based observations following a protocol established by the Carbon-Land Model Intercomparison Project. The land surface fluxes and vegetation structural properties are reasonably well simulated by JeDi-DGVM, and compare favourably with other state-of-the-art global vegetation models. We also evaluate the simulated patterns of functional diversity and the sensitivity of the JeDi-DGVM modelling approach to the number of sampled strategies. Altogether, the results demonstrate the

  7. Modelling of electron contamination in clinical photon beams for Monte Carlo dose calculation

    International Nuclear Information System (INIS)

    Yang, J; Li, J S; Qin, L; Xiong, W; Ma, C-M

    2004-01-01

    The purpose of this work is to model electron contamination in clinical photon beams and to commission the source model using measured data for Monte Carlo treatment planning. In this work, a planar source is used to represent the contaminant electrons at a plane above the upper jaws. The source size depends on the dimensions of the field size at the isocentre. The energy spectra of the contaminant electrons are predetermined using Monte Carlo simulations for photon beams from different clinical accelerators. A 'random creep' method is employed to derive the weight of the electron contamination source by matching Monte Carlo calculated monoenergetic photon and electron percent depth-dose (PDD) curves with measured PDD curves. We have integrated this electron contamination source into a previously developed multiple source model and validated the model for photon beams from Siemens PRIMUS accelerators. The EGS4 based Monte Carlo user code BEAM and MCSIM were used for linac head simulation and dose calculation. The Monte Carlo calculated dose distributions were compared with measured data. Our results showed good agreement (less than 2% or 2 mm) for 6, 10 and 18 MV photon beams

  8. Modeling the economic outcomes of immuno-oncology drugs: alternative model frameworks to capture clinical outcomes.

    Science.gov (United States)

    Gibson, E J; Begum, N; Koblbauer, I; Dranitsaris, G; Liew, D; McEwan, P; Tahami Monfared, A A; Yuan, Y; Juarez-Garcia, A; Tyas, D; Lees, M

    2018-01-01

    Economic models in oncology are commonly based on the three-state partitioned survival model (PSM) distinguishing between progression-free and progressive states. However, the heterogeneity of responses observed in immuno-oncology (I-O) suggests that new approaches may be appropriate to reflect disease dynamics meaningfully. This study explored the impact of incorporating immune-specific health states into economic models of I-O therapy. Two variants of the PSM and a Markov model were populated with data from one clinical trial in metastatic melanoma patients. Short-term modeled outcomes were benchmarked to the clinical trial data and a lifetime model horizon provided estimates of life years and quality adjusted life years (QALYs). The PSM-based models produced short-term outcomes closely matching the trial outcomes. Adding health states generated increased QALYs while providing a more granular representation of outcomes for decision making. The Markov model gave the greatest level of detail on outcomes but gave short-term results which diverged from those of the trial (overstating year 1 progression-free survival by around 60%). Increased sophistication in the representation of disease dynamics in economic models is desirable when attempting to model treatment response in I-O. However, the assumptions underlying different model structures and the availability of data for health state mapping may be important limiting factors.

  9. Study protocol for a transversal study to develop a screening model for excessive gambling behaviours on a representative sample of users of French authorised gambling websites.

    Science.gov (United States)

    Perrot, Bastien; Hardouin, Jean-Benoit; Costes, Jean-Michel; Caillon, Julie; Grall-Bronnec, Marie; Challet-Bouju, Gaëlle

    2017-05-17

    Since the legalisation of online gambling in France in 2010, gambling operators must implement responsible gambling measures to prevent excessive gambling practices. However, actually there is no screening procedure for identifying problematic gamblers. Although several studies have already been performed using several data sets from online gambling operators, the authors deplored several methodological and clinical limits that prevent scientifically validating the existence of problematic gambling behaviour. The aim of this study is to develop a model for screening excessive gambling practices based on the gambling behaviours observed on French gambling websites, coupled with a clinical validation. The research is divided into three successive stages. All analyses will be performed for each major type of authorised online gambling in France. The first stage aims at defining a typology of users of French authorised gambling websites based on their gambling behaviour. This analysis will be based on data from the Authority for Regulating Online Gambling (ARJEL) and the Française Des Jeux (FDJ). For the second stage aiming at determining a score to predict whether a gambler is problematic or not, we will cross answers from the Canadian Problem Gambling Index with real gambling data. The objective of the third stage is to clinically validate the score previously developed. Results from the screening model will be compared (using sensitivity, specificity, area under the curve, and positive and negative predictive values) with the diagnosis obtained with a telephone clinical interview, including diagnostic criteria for gambling addiction. This study was approved by the local Research Ethics Committee (GNEDS) on 25 March 2015. Results will be presented in national and international conferences, submitted to peer-reviewed journals and will be part of a PhD thesis. A final report with the study results will be presented to the ARJEL, especially the final screening model

  10. Application of qualitative reasoning with functional knowledge represented by Multilevel Flow Modeling to diagnosis of accidental situation in nuclear power plant

    International Nuclear Information System (INIS)

    Yoshida, Kazuo; Tanabe, Fumiya; Kawase, Katumi.

    1996-01-01

    It has been proposed to use the Multilevel Flow Modeling (MFM) by M. Lind as a framework for functional knowledge representation for qualitative reasoning in a complex process system such as nuclear power plant. To build a knowledge base with MFM framework makes it possible to represent functional characteristics in different levels of abstraction and aggregation. A pilot inference system based on the qualitative reasoning with MFM has been developed to diagnose a cause of abnormal events in a typical PWR power plant. Some single failure events has been diagnosed with this system to verify the proposed method. In the verification study, some investigation has been also performed to clarify the effects of this knowledge representation in efficiency of reasoning and ambiguity of qualitative reasoning. (author)

  11. Nurse-directed care model in a psychiatric hospital: a model for clinical accountability.

    Science.gov (United States)

    E-Morris, Marlene; Caldwell, Barbara; Mencher, Kathleen J; Grogan, Kimberly; Judge-Gorny, Margaret; Patterson, Zelda; Christopher, Terrian; Smith, Russell C; McQuaide, Teresa

    2010-01-01

    The focus on recovery for persons with severe and persistent mental illness is leading state psychiatric hospitals to transform their method of care delivery. This article describes a quality improvement project involving a hospital's administration and multidisciplinary state-university affiliation that collaborated in the development and implementation of a nursing care delivery model in a state psychiatric hospital. The quality improvement project team instituted a new model to promote the hospital's vision of wellness and recovery through utilization of the therapeutic relationship and greater clinical accountability. Implementation of the model was accomplished in 2 phases: first, the establishment of a structure to lay the groundwork for accountability and, second, the development of a mechanism to provide a clinical supervision process for staff in their work with clients. Effectiveness of the model was assessed by surveys conducted at baseline and after implementation. Results indicated improvement in clinical practices and client living environment. As a secondary outcome, these improvements appeared to be associated with increased safety on the units evidenced by reduction in incidents of seclusion and restraint. Restructuring of the service delivery system of care so that clients are the center of clinical focus improves safety and can enhance the staff's attention to work with clients on their recovery. The role of the advanced practice nurse can influence the recovery of clients in state psychiatric hospitals. Future research should consider the impact on clients and their perceptions of the new service models.

  12. New, strategic outsourcing models to meet changing clinical development needs.

    Science.gov (United States)

    Jones, Janet; Minor, Michael

    2010-04-01

    The impact of increasing clinical costs and the need for more data to support higher efficacy demands and overcome regulatory hurdles for market entry means that every Company is faced with the challenge of how to do more with a smaller budget. As budgets get squeezed the pharmaceutical Industry has been looking at how to contain or reduce cost and support an increased number of projects. With the growing sophistication of outsourcing, this is an increasingly important area of focus. Some Pharmaceutical Companies have moved from tactical, case by case, outsourcing to new, more strategic relationships, which involve outsourcing functions that were historically held as core pharmaceutical functions. An increasing number of Sponsors are looking at strategic relationships which are based on more creative outsourcing approaches. As the need and sophistication of these outsourcing models and the sponsors / CROs involved in them, these approaches are becoming more transformational and need to be based on a strong partnership. Lessons learned from working with sponsors in a partnership model have been examined and two key challenges addressed in detail: the need for bilateral central control though a strong governance model and the importance of early planning and commitment.

  13. New, strategic outsourcing models to meet changing clinical development needs

    Directory of Open Access Journals (Sweden)

    Janet Jones

    2010-01-01

    Full Text Available The impact of increasing clinical costs and the need for more data to support higher efficacy demands and overcome regulatory hurdles for market entry means that every Company is faced with the challenge of how to do more with a smaller budget. As budgets get squeezed the pharmaceutical Industry has been looking at how to contain or reduce cost and support an increased number of projects. With the growing sophistication of outsourcing, this is an increasingly important area of focus. Some Pharmaceutical Companies have moved from tactical, case by case, outsourcing to new, more strategic relationships, which involve outsourcing functions that were historically held as core pharmaceutical functions. An increasing number of Sponsors are looking at strategic relationships which are based on more creative outsourcing approaches. As the need and sophistication of these outsourcing models and the sponsors / CROs involved in them, these approaches are becoming more transformational and need to be based on a strong partnership. Lessons learned from working with sponsors in a partnership model have been examined and two key challenges addressed in detail: the need for bilateral central control though a strong governance model and the importance of early planning and commitment.

  14. Models to Study NK Cell Biology and Possible Clinical Application.

    Science.gov (United States)

    Zamora, Anthony E; Grossenbacher, Steven K; Aguilar, Ethan G; Murphy, William J

    2015-08-03

    Natural killer (NK) cells are large granular lymphocytes of the innate immune system, responsible for direct targeting and killing of both virally infected and transformed cells. NK cells rapidly recognize and respond to abnormal cells in the absence of prior sensitization due to their wide array of germline-encoded inhibitory and activating receptors, which differs from the receptor diversity found in B and T lymphocytes that is due to the use of recombination-activation gene (RAG) enzymes. Although NK cells have traditionally been described as natural killers that provide a first line of defense prior to the induction of adaptive immunity, a more complex view of NK cells is beginning to emerge, indicating they may also function in various immunoregulatory roles and have the capacity to shape adaptive immune responses. With the growing appreciation for the diverse functions of NK cells, and recent technological advancements that allow for a more in-depth understanding of NK cell biology, we can now begin to explore new ways to manipulate NK cells to increase their clinical utility. In this overview unit, we introduce the reader to various aspects of NK cell biology by reviewing topics ranging from NK cell diversity and function, mouse models, and the roles of NK cells in health and disease, to potential clinical applications. © 2015 by John Wiley & Sons, Inc. Copyright © 2015 John Wiley & Sons, Inc.

  15. Implementation of a physically-based scheme representing light-absorbing impurities deposition, evolution and radiative impacts in the SURFEX/Crocus model

    Science.gov (United States)

    Tuzet, F.; Dumont, M.; Lafaysse, M.; Hagenmuller, P.; Arnaud, L.; Picard, G.; Morin, S.

    2017-12-01

    Light-absorbing impurities decrease snow albedo, increasing the amount of solar energy absorbed by the snowpack. Its most intuitive impact is to accelerate snow melt. However the presence of a layer highly concentrated in light-absorbing impurities in the snowpack also modify its temperature profile affecting snow metamorphism. New capabilities have been implemented in the detailed snowpack model SURFEX/ISBA-Crocus (referred to as Crocus) to account for impurities deposition and evolution within the snowpack (Tuzet et al., 2017, TCD). Once deposited, the model computes impurities mass evolution until snow melts out. Taking benefits of the recent inclusion of the spectral radiative transfer model TARTES in Crocus, the model explicitly represents the radiative impacts of light-absorbing impurities in snow. In the Pyrenees mountain range, strong sporadic Saharan dust deposition (referred to as dust outbreaks) can occur during the snow season leading some snow layers in the snowpack to contain high concentrations of mineral dust. One of the major events of the past years occurred on February 2014, affecting the whole southern Europe. During the weeks following this dust outbreak a strong avalanche activity was reported in the Aran valley (Pyrenees, Spain). For now, the link between the dust outbreak and the avalanche activity is not demonstrated.We investigate the impact of this dust outbreak on the snowpack stability in the Aran valley using the Crocus model, trying to determine whether the snowpack instability observed after the dust outbreak can be related to the presence of dust. SAFRAN-reanalysis meteorological data are used to drive the model on several altitudes, slopes and aspects. For each slope configuration two different simulations are run; one without dust and one simulating the dust outbreak of February 2014.The two corresponding simulations are then compared to assess the role of impurities on snow metamorphism and stability.On this example, we

  16. Business Models, Vaccination Services, and Public Health Relationships of Retail Clinics: A Qualitative Study.

    Science.gov (United States)

    Arthur, Bayo C; Fisher, Allison Kennedy; Shoemaker, Sarah J; Pozniak, Alyssa; Stokley, Shannon

    2015-01-01

    Despite the rapid growth of retail clinics (RCs), literature is limited in terms of how these facilities offer preventive services, particularly vaccination services. The purpose of this study was to obtain an in-depth understanding of the RC business model pertaining to vaccine offerings, profitability, and decision making. From March to June 2009, we conducted 15 interviews with key individuals from three types of organizations: 12 representatives of RC corporations, 2 representatives of retail hosts (i.e., stores in which the RCs are located), and 1 representative of an industry association. We analyzed interview transcripts qualitatively. Our results indicate that consumer demand and profitability were the main drivers in offering vaccinations. RCs in this sample primarily offered vaccinations to adults and adolescents, and they were not well integrated with local public health and immunization registries. Our findings demonstrate the potential for stronger linkages with public health in these settings. The findings also may help inform future research to increase patient access to vaccination services at RCs.

  17. Distributions and climate effects of atmospheric aerosols from the preindustrial era to 2100 along Representative Concentration Pathways (RCPs simulated using the global aerosol model SPRINTARS

    Directory of Open Access Journals (Sweden)

    T. Takemura

    2012-12-01

    Full Text Available Global distributions and associated climate effects of atmospheric aerosols were simulated using a global aerosol climate model, SPRINTARS, from 1850 to the present day and projected forward to 2100. Aerosol emission inventories used by the Coupled Model Intercomparison Project Phase 5 (CMIP5 were applied to this study. Scenarios based on the Representative Concentration Pathways (RCPs were used for the future projection. Aerosol loading in the atmosphere has already peaked and is now reducing in Europe and North America. However, in Asia where rapid economic growth is ongoing, aerosol loading is estimated to reach a maximum in the first half of this century. Atmospheric aerosols originating from the burning of biomass have maintained high loadings throughout the 21st century in Africa, according to the RCPs. Evolution of the adjusted forcing by direct and indirect aerosol effects over time generally correspond to the aerosol loading. The probable future pathways of global mean forcing differ based on the aerosol direct effect for different RCPs. Because aerosol forcing will be close to the preindustrial level by the end of the 21st century for all RCPs despite the continuous increases in greenhouse gases, global warming will be accelerated with reduced aerosol negative forcing.

  18. [Experimental and clinical studies of flomoxef in the field of obstetrics and gynecology. Representative Committee Members of the Research Team for Infections in the Field of Obstetrics and Gynecology].

    Science.gov (United States)

    Matsuda, S; Okada, H; Ninomiya, K; Shimizu, T; Noda, K; Deguchi, K

    1988-12-01

    Flomoxef (FMOX) has a broad antibacterial spectrum against Gram-positive and Gram-negative bacteria; especially its potent antibacterial activity against Staphylococcus aureus is a significant advantage that may not be found with other cephem compounds. In our determination of its antibacterial potency against various clinical isolates obtained from clinical materials (amniotic fluid, intrauterine secretions, exudates of the pelvic dead space) of patients with various infections, we obtained results representing specific features of this drug. From the results, the drug may be expected to produce an excellent effect in the treatment of various infections. Our study on drug concentrations in body fluids and genital tissues demonstrated a good transfer of this drug into various tissues; in every tissue examined, the drug administered by the usual method in the usual dose yielded a concentration exceeding MIC for principal pathogens, thus promising a good clinical response. Indeed a high clinical efficacy rate of 90.1% (good to very good responses) was obtained in a clinical trial involving 222 cases. Administration of the drug in 2 g quantity daily produced a high response rate of 92.8%. It was especially noteworthy that a good response was obtained in 30 of 32 cases (93.8%) in which other cephem compounds had failed. In evaluation of the bacteriological effect, furthermore, the drug showed an excellent rate of bacterial elimination. In conclusion, this drug is expected to be greatly useful in the light of its good transfer into genital tissues and its strong antibacterial activities against Gram-positive cocci, Gram-negative bacteria and anaerobes as well as against multiple bacterial infections predominating among women with genital infections.

  19. Bone Turnover Status: Classification Model and Clinical Implications

    Science.gov (United States)

    Fisher, Alexander; Fisher, Leon; Srikusalanukul, Wichat; Smith, Paul N

    2018-01-01

    Aim: To develop a practical model for classification bone turnover status and evaluate its clinical usefulness. Methods: Our classification of bone turnover status is based on internationally recommended biomarkers of both bone formation (N-terminal propeptide of type1 procollagen, P1NP) and bone resorption (beta C-terminal cross-linked telopeptide of type I collagen, bCTX), using the cutoffs proposed as therapeutic targets. The relationships between turnover subtypes and clinical characteristic were assessed in1223 hospitalised orthogeriatric patients (846 women, 377 men; mean age 78.1±9.50 years): 451(36.9%) subjects with hip fracture (HF), 396(32.4%) with other non-vertebral (non-HF) fractures (HF) and 376 (30.7%) patients without fractures. Resalts: Six subtypes of bone turnover status were identified: 1 - normal turnover (P1NP>32 μg/L, bCTX≤0.250 μg/L and P1NP/bCTX>100.0[(median value]); 2- low bone formation (P1NP ≤32 μg/L), normal bone resorption (bCTX≤0.250 μg/L) and P1NP/bCTX>100.0 (subtype2A) or P1NP/bCTX0.250 μg/L) and P1NP/bCTXturnover (both markers elevated ) and P1NP/bCTX>100.0 (subtype 4A) or P1NP/bCTX75 years and hyperparathyroidism. Hypoalbuminaemia and not using osteoporotic therapy were two independent indicators common for subtypes 3, 4A and 4B; these three subtypes were associated with in-hospital mortality. Subtype 3 was associated with fractures (OR 1.7, for HF OR 2.4), age>75 years, chronic heart failure (CHF), anaemia, and history of malignancy, and predicted post-operative myocardial injury, high inflammatory response and length of hospital stay (LOS) above10 days. Subtype 4A was associated with chronic kidney disease (CKD), anaemia, history of malignancy and walking aids use and predicted LOS>20 days, but was not discriminative for fractures. Subtype 4B was associated with fractures (OR 2.1, for HF OR 2.5), age>75 years, CKD and indicated risks of myocardial injury, high inflammatory response and LOS>10 days. Conclusions: We

  20. List of Accredited Representatives

    Data.gov (United States)

    Department of Veterans Affairs — VA accreditation is for the sole purpose of providing representation services to claimants before VA and does not imply that a representative is qualified to provide...

  1. Author: MA du Plessis CLINICAL LEGAL EDUCATION MODELS ...

    African Journals Online (AJOL)

    21892687

    various aspects of legal practice and engage in community service learning ... components, namely clinical duty, classroom teaching and clinician/student tutorial ..... Vawda YA "Learning from Experience: The Art and Science of Clinical Law" ... Lennertz M Date Unknown Developing Legal Clinics in Brazil: Remarks on the.

  2. Profiling Fast Healthcare Interoperability Resources (FHIR) of Family Health History based on the Clinical Element Models.

    Science.gov (United States)

    Lee, Jaehoon; Hulse, Nathan C; Wood, Grant M; Oniki, Thomas A; Huff, Stanley M

    2016-01-01

    In this study we developed a Fast Healthcare Interoperability Resources (FHIR) profile to support exchanging a full pedigree based family health history (FHH) information across multiple systems and applications used by clinicians, patients, and researchers. We used previously developed clinical element models (CEMs) that are capable of representing the FHH information, and derived essential data elements including attributes, constraints, and value sets. We analyzed gaps between the FHH CEM elements and existing FHIR resources. Based on the analysis, we developed a profile that consists of 1) FHIR resources for essential FHH data elements, 2) extensions for additional elements that were not covered by the resources, and 3) a structured definition to integrate patient and family member information in a FHIR message. We implemented the profile using an open-source based FHIR framework and validated it using patient-entered FHH data that was captured through a locally developed FHH tool.

  3. Coping with perceived weight discrimination: testing a theoretical model for examining the relationship between perceived weight discrimination and depressive symptoms in a representative sample of individuals with obesity.

    Science.gov (United States)

    Spahlholz, J; Pabst, A; Riedel-Heller, S G; Luck-Sikorski, C

    2016-12-01

    The association between obesity and perceived weight discrimination has been investigated in several studies. Although there is evidence that perceived weight discrimination is associated with negative outcomes on psychological well-being, there is a lack of research examining possible buffering effects of coping strategies in dealing with experiences of weight discrimination. The present study aims to fill that gap. We examined the relationship between perceived weight discrimination and depressive symptoms and tested whether problem-solving strategies and/or avoidant coping strategies mediated this effect. Using structural equation modeling, we analyzed representative cross-sectional data of n=484 German-speaking individuals with obesity (BMI⩾30 kg m -2 ), aged 18 years and older. Results revealed a direct effect of perceived weight discrimination on depressive symptoms. Further, the data supported a mediational linkage for avoidant coping strategies, not for problem-solving strategies. Higher scores of perceived weight discrimination experiences were associated with both coping strategies, but only avoidant coping strategies were positively linked to more symptoms of depression. Perceived weight discrimination was associated with increased depressive symptoms both directly and indirectly through situational coping strategies. Avoidant coping has the potential to exacerbate depressive symptoms, whereas problem-solving strategies were ineffective in dealing with experiences of weight discrimination. We emphasize the importance of coping strategies in dealing with experiences of weight discrimination and the need to distinguish between using a strategy and benefiting from it without detriment.

  4. A Quality Model to Select Patients in Cupping Therapy Clinics: A New Tool for Ensuring Safety in Clinical Practice.

    Science.gov (United States)

    Aboushanab, Tamer; AlSanad, Saud

    2018-06-08

    Cupping therapy is a popular treatment in various countries and regions, including Saudi Arabia. Cupping therapy is regulated in Saudi Arabia by the National Center for Complementary and Alternative Medicine (NCCAM), Ministry of Health. The authors recommend that this quality model for selecting patients in cupping clinics - first version (QMSPCC-1) - be used routinely as part of clinical practice and quality management in cupping clinics. The aim of the quality model is to ensure the safety of patients and to introduce and facilitate quality and auditing processes in cupping therapy clinics. Clinical evaluation of this tool is recommended. Continued development, re-evaluation and reassessment of this tool are important. Copyright © 2018. Published by Elsevier B.V.

  5. Representative Agricultural Pathways: A Trans-Disciplinary Approach to Agricultural Model Inter-comparison, Improvement, Climate Impact Assessment and Stakeholder Engagement

    Science.gov (United States)

    Antle, J. M.; Valdivia, R. O.; Claessens, L.; Nelson, G. C.; Rosenzweig, C.; Ruane, A. C.; Vervoort, J.

    2013-12-01

    The global change research community has recognized that new pathway and scenario concepts are needed to implement impact and vulnerability assessment that is logically consistent across local, regional and global scales. For impact and vulnerability assessment, new socio-economic pathway and scenario concepts are being developed. Representative Agricultural Pathways (RAPs) are designed to extend global pathways to provide the detail needed for global and regional assessment of agricultural systems. In addition, research by the Agricultural Model Inter-comparison and Improvement Project (AgMIP) shows that RAPs provide a powerful way to engage stakeholders in climate-related research throughout the research process and in communication of research results. RAPs are based on the integrated assessment framework developed by AgMIP. This framework shows that both bio-physical and socio-economic drivers are essential components of agricultural pathways and logically precede the definition of adaptation and mitigation scenarios that embody associated capabilities and challenges. This approach is based on a trans-disciplinary process for designing pathways and then translating them into parameter sets for bio-physical and economic models that are components of agricultural integrated assessments of climate impact, adaptation and mitigation. RAPs must be designed to be part of a logically consistent set of drivers and outcomes from global to regional and local. Global RAPs are designed to be consistent with higher-level global socio-economic pathways, but add key agricultural drivers such as agricultural growth trends that are not specified in more general pathways, as illustrated in a recent inter-comparison of global agricultural models. To create pathways at regional or local scales, further detail is needed. At this level, teams of scientists and other experts with knowledge of the agricultural systems and regions work together through a step-wise process. Experiences

  6. Assessment of the Clinical Trainer as a Role Model: A Role Model Apperception Tool (RoMAT)

    NARCIS (Netherlands)

    Jochemsen-van der Leeuw, H. G. A. Ria; van Dijk, Nynke; Wieringa-de Waard, Margreet

    2014-01-01

    Purpose Positive role modeling by clinical trainers is important for helping trainees learn professional and competent behavior. The authors developed and validated an instrument to assess clinical trainers as role models: the Role Model Apperception Tool (RoMAT). Method On the basis of a 2011

  7. Chronic stress impacts the cardiovascular system: animal models and clinical outcomes.

    Science.gov (United States)

    Golbidi, Saeid; Frisbee, Jefferson C; Laher, Ismail

    2015-06-15

    Psychological stresses are associated with cardiovascular diseases to the extent that cardiovascular diseases are among the most important group of psychosomatic diseases. The longstanding association between stress and cardiovascular disease exists despite a large ambiguity about the underlying mechanisms. An array of possibilities have been proposed including overactivity of the autonomic nervous system and humoral changes, which then converge on endothelial dysfunction that initiates unwanted cardiovascular consequences. We review some of the features of the two most important stress-activated systems, i.e., the humoral and nervous systems, and focus on alterations in endothelial function that could ensue as a result of these changes. Cardiac and hematologic consequences of stress are also addressed briefly. It is likely that activation of the inflammatory cascade in association with oxidative imbalance represents key pathophysiological components of stress-induced cardiovascular changes. We also review some of the commonly used animal models of stress and discuss the cardiovascular outcomes reported in these models of stress. The unique ability of animals for adaptation under stressful conditions lessens the extrapolation of laboratory findings to conditions of human stress. An animal model of unpredictable chronic stress, which applies various stress modules in a random fashion, might be a useful solution to this predicament. The use of stress markers as indicators of stress intensity is also discussed in various models of animal stress and in clinical studies. Copyright © 2015 the American Physiological Society.

  8. Representing vision and blindness.

    Science.gov (United States)

    Ray, Patrick L; Cox, Alexander P; Jensen, Mark; Allen, Travis; Duncan, William; Diehl, Alexander D

    2016-01-01

    There have been relatively few attempts to represent vision or blindness ontologically. This is unsurprising as the related phenomena of sight and blindness are difficult to represent ontologically for a variety of reasons. Blindness has escaped ontological capture at least in part because: blindness or the employment of the term 'blindness' seems to vary from context to context, blindness can present in a myriad of types and degrees, and there is no precedent for representing complex phenomena such as blindness. We explore current attempts to represent vision or blindness, and show how these attempts fail at representing subtypes of blindness (viz., color blindness, flash blindness, and inattentional blindness). We examine the results found through a review of current attempts and identify where they have failed. By analyzing our test cases of different types of blindness along with the strengths and weaknesses of previous attempts, we have identified the general features of blindness and vision. We propose an ontological solution to represent vision and blindness, which capitalizes on resources afforded to one who utilizes the Basic Formal Ontology as an upper-level ontology. The solution we propose here involves specifying the trigger conditions of a disposition as well as the processes that realize that disposition. Once these are specified we can characterize vision as a function that is realized by certain (in this case) biological processes under a range of triggering conditions. When the range of conditions under which the processes can be realized are reduced beyond a certain threshold, we are able to say that blindness is present. We characterize vision as a function that is realized as a seeing process and blindness as a reduction in the conditions under which the sight function is realized. This solution is desirable because it leverages current features of a major upper-level ontology, accurately captures the phenomenon of blindness, and can be

  9. Time series analysis as input for clinical predictive modeling: modeling cardiac arrest in a pediatric ICU.

    Science.gov (United States)

    Kennedy, Curtis E; Turley, James P

    2011-10-24

    Thousands of children experience cardiac arrest events every year in pediatric intensive care units. Most of these children die. Cardiac arrest prediction tools are used as part of medical emergency team evaluations to identify patients in standard hospital beds that are at high risk for cardiac arrest. There are no models to predict cardiac arrest in pediatric intensive care units though, where the risk of an arrest is 10 times higher than for standard hospital beds. Current tools are based on a multivariable approach that does not characterize deterioration, which often precedes cardiac arrests. Characterizing deterioration requires a time series approach. The purpose of this study is to propose a method that will allow for time series data to be used in clinical prediction models. Successful implementation of these methods has the potential to bring arrest prediction to the pediatric intensive care environment, possibly allowing for interventions that can save lives and prevent disabilities. We reviewed prediction models from nonclinical domains that employ time series data, and identified the steps that are necessary for building predictive models using time series clinical data. We illustrate the method by applying it to the specific case of building a predictive model for cardiac arrest in a pediatric intensive care unit. Time course analysis studies from genomic analysis provided a modeling template that was compatible with the steps required to develop a model from clinical time series data. The steps include: 1) selecting candidate variables; 2) specifying measurement parameters; 3) defining data format; 4) defining time window duration and resolution; 5) calculating latent variables for candidate variables not directly measured; 6) calculating time series features as latent variables; 7) creating data subsets to measure model performance effects attributable to various classes of candidate variables; 8) reducing the number of candidate features; 9

  10. The effectiveness of clinical teaching of mental health courses in nursing using clinical supervision and Kirkpatrick's model.

    Science.gov (United States)

    Maddineshat, Maryam; Hashemi, Mitra; Besharati, Reza; Gholami, Sepideh; Ghavidel, Fatemeh

    2018-01-01

    Clinical experience associated with the fear and anxiety of nursing students in the psychiatric unit. Mental health nursing instructors find it challenging to teach nursing students to deal with patients with mental disorders in an environment where they need to provide patient teaching and clinical decision-making based on evidence and new technology. To measure the effectiveness of clinical teaching of mental health courses in nursing using clinical supervision and Kirkpatrick's model evaluation in the psychiatry unit of Imam Reza Hospital, Bojnurd, Iran. This cross-sectional study was carried out from 2011 to 2016 on 76 nursing students from a university as part of a clinical mental health course in two semesters. The students were selected by a non-probable convenient sampling method. After completing their clinical education, each student responded to checklist questions based on the four-level Kirkpatrick's model evaluation and open questions relating to clinical supervision. Finally, all data was analyzed using the SPSS version 16. The students have evaluated clinical supervision as a useful approach, and appreciated the instructor's supportive behavior during teaching and imparting clinical skills. This has made them feel relaxed at the end of the clinical teaching course. In addition, in the evaluation through Kirkpatrick's model, more than 70% of the students have been satisfied with the method of conducting the teaching and average score of nursing students' attitude toward mental health students: Their mean self-confidence score was 18.33±1.69, and the mean score of their performance in the study was evaluated to be 93.74±5.3 from 100 points. The results of clinical mental health teaching through clinical supervision and Kirkpatrick's model evaluation show that the satisfaction, self-esteem, attitude, and skill of nursing students are excellent, thereby portraying the effectiveness of clinical teaching. But this program still needs to be reformed. To

  11. Management units radio physics hospital clinic: New management model?

    International Nuclear Information System (INIS)

    Iborra Oquendo, M.; Angulo Pain, E.; Castro Ramirez, I.; Quinones Rodriguez, L. A.; Urena Llinares, A.; Richarter Reina, J. M.; Lupiani Castellanos, J.; Ramos Caballero, L. I.

    2011-01-01

    Clinical management in the Andalusian Health Service is a process of organizational design that allows professionals to incorporate the management of resources used in their own clinical practice. In the Clinical Management Units activity develops according to different objectives, among them: encourage the involvement of health professionals in managing the centers, enhance continuity of care between the two levels of care, improve work organization and raise patient satisfaction.

  12. Models of clinical reasoning with a focus on general practice: A critical review.

    Science.gov (United States)

    Yazdani, Shahram; Hosseinzadeh, Mohammad; Hosseini, Fakhrolsadat

    2017-10-01

    Diagnosis lies at the heart of general practice. Every day general practitioners (GPs) visit patients with a wide variety of complaints and concerns, with often minor but sometimes serious symptoms. General practice has many features which differentiate it from specialty care setting, but during the last four decades little attention was paid to clinical reasoning in general practice. Therefore, we aimed to critically review the clinical reasoning models with a focus on the clinical reasoning in general practice or clinical reasoning of general practitioners to find out to what extent the existing models explain the clinical reasoning specially in primary care and also identity the gaps of the model for use in primary care settings. A systematic search to find models of clinical reasoning were performed. To have more precision, we excluded the studies that focused on neurobiological aspects of reasoning, reasoning in disciplines other than medicine decision making or decision analysis on treatment or management plan. All the articles and documents were first scanned to see whether they include important relevant contents or any models. The selected studies which described a model of clinical reasoning in general practitioners or with a focus on general practice were then reviewed and appraisal or critics of other authors on these models were included. The reviewed documents on the model were synthesized. Six models of clinical reasoning were identified including hypothetic-deductive model, pattern recognition, a dual process diagnostic reasoning model, pathway for clinical reasoning, an integrative model of clinical reasoning, and model of diagnostic reasoning strategies in primary care. Only one model had specifically focused on general practitioners reasoning. A Model of clinical reasoning that included specific features of general practice to better help the general practitioners with the difficulties of clinical reasoning in this setting is needed.

  13. Models of clinical reasoning with a focus on general practice: a critical review

    Directory of Open Access Journals (Sweden)

    SHAHRAM YAZDANI

    2017-10-01

    Full Text Available Introduction: Diagnosis lies at the heart of general practice. Every day general practitioners (GPs visit patients with a wide variety of complaints and concerns, with often minor but sometimes serious symptoms. General practice has many features which differentiate it from specialty care setting, but during the last four decades little attention was paid to clinical reasoning in general practice. Therefore, we aimed to critically review the clinical reasoning models with a focus on the clinical reasoning in general practice or clinical reasoning of general practitioners to find out to what extent the existing models explain the clinical reasoning specially in primary care and also identity the gaps of the model for use in primary care settings Methods: A systematic search to find models of clinical reasoning were performed. To have more precision, we excluded the studies that focused on neurobiological aspects of reasoning, reasoning in disciplines other than medicine decision making or decision analysis on treatment or management plan. All the articles and documents were first scanned to see whether they include important relevant contents or any models. The selected studies which described a model of clinical reasoning in general practitioners or with a focus on general practice were then reviewed and appraisal or critics of other authors on these models were included. The reviewed documents on the model were synthesized Results: Six models of clinical reasoning were identified including hypothetic-deductive model, pattern recognition, a dual process diagnostic reasoning model, pathway for clinical reasoning, an integrative model of clinical reasoning, and model of diagnostic reasoning strategies in primary care. Only one model had specifically focused on general practitioners reasoning. Conclusion: A Model of clinical reasoning that included specific features of general practice to better help the general practitioners with the difficulties

  14. Modeling and validating Bayesian accrual models on clinical data and simulations using adaptive priors.

    Science.gov (United States)

    Jiang, Yu; Simon, Steve; Mayo, Matthew S; Gajewski, Byron J

    2015-02-20

    Slow recruitment in clinical trials leads to increased costs and resource utilization, which includes both the clinic staff and patient volunteers. Careful planning and monitoring of the accrual process can prevent the unnecessary loss of these resources. We propose two hierarchical extensions to the existing Bayesian constant accrual model: the accelerated prior and the hedging prior. The new proposed priors are able to adaptively utilize the researcher's previous experience and current accrual data to produce the estimation of trial completion time. The performance of these models, including prediction precision, coverage probability, and correct decision-making ability, is evaluated using actual studies from our cancer center and simulation. The results showed that a constant accrual model with strongly informative priors is very accurate when accrual is on target or slightly off, producing smaller mean squared error, high percentage of coverage, and a high number of correct decisions as to whether or not continue the trial, but it is strongly biased when off target. Flat or weakly informative priors provide protection against an off target prior but are less efficient when the accrual is on target. The accelerated prior performs similar to a strong prior. The hedging prior performs much like the weak priors when the accrual is extremely off target but closer to the strong priors when the accrual is on target or only slightly off target. We suggest improvements in these models and propose new models for future research. Copyright © 2014 John Wiley & Sons, Ltd.

  15. Standardizing data exchange for clinical research protocols and case report forms: An assessment of the suitability of the Clinical Data Interchange Standards Consortium (CDISC) Operational Data Model (ODM).

    Science.gov (United States)

    Huser, Vojtech; Sastry, Chandan; Breymaier, Matthew; Idriss, Asma; Cimino, James J

    2015-10-01

    Efficient communication of a clinical study protocol and case report forms during all stages of a human clinical study is important for many stakeholders. An electronic and structured study representation format that can be used throughout the whole study life-span can improve such communication and potentially lower total study costs. The most relevant standard for representing clinical study data, applicable to unregulated as well as regulated studies, is the Operational Data Model (ODM) in development since 1999 by the Clinical Data Interchange Standards Consortium (CDISC). ODM's initial objective was exchange of case report forms data but it is increasingly utilized in other contexts. An ODM extension called Study Design Model, introduced in 2011, provides additional protocol representation elements. Using a case study approach, we evaluated ODM's ability to capture all necessary protocol elements during a complete clinical study lifecycle in the Intramural Research Program of the National Institutes of Health. ODM offers the advantage of a single format for institutions that deal with hundreds or thousands of concurrent clinical studies and maintain a data warehouse for these studies. For each study stage, we present a list of gaps in the ODM standard and identify necessary vendor or institutional extensions that can compensate for such gaps. The current version of ODM (1.3.2) has only partial support for study protocol and study registration data mainly because it is outside the original development goal. ODM provides comprehensive support for representation of case report forms (in both the design stage and with patient level data). Inclusion of requirements of observational, non-regulated or investigator-initiated studies (outside Food and Drug Administration (FDA) regulation) can further improve future revisions of the standard. Published by Elsevier Inc.

  16. An ontology-driven, case-based clinical decision support model for removable partial denture design

    Science.gov (United States)

    Chen, Qingxiao; Wu, Ji; Li, Shusen; Lyu, Peijun; Wang, Yong; Li, Miao

    2016-06-01

    We present the initial work toward developing a clinical decision support model for specific design of removable partial dentures (RPDs) in dentistry. We developed an ontological paradigm to represent knowledge of a patient’s oral conditions and denture component parts. During the case-based reasoning process, a cosine similarity algorithm was applied to calculate similarity values between input patients and standard ontology cases. A group of designs from the most similar cases were output as the final results. To evaluate this model, the output designs of RPDs for 104 randomly selected patients were compared with those selected by professionals. An area under the curve of the receiver operating characteristic (AUC-ROC) was created by plotting true-positive rates against the false-positive rate at various threshold settings. The precision at position 5 of the retrieved cases was 0.67 and at the top of the curve it was 0.96, both of which are very high. The mean average of precision (MAP) was 0.61 and the normalized discounted cumulative gain (NDCG) was 0.74 both of which confirmed the efficient performance of our model. All the metrics demonstrated the efficiency of our model. This methodology merits further research development to match clinical applications for designing RPDs. This paper is organized as follows. After the introduction and description of the basis for the paper, the evaluation and results are presented in Section 2. Section 3 provides a discussion of the methodology and results. Section 4 describes the details of the ontology, similarity algorithm, and application.

  17. A fingerprinting mixing model approach to generate uniformly representative solutions for distributed contributions of sediment sources in a Pyrenean drainage basin

    Science.gov (United States)

    Palazón, Leticia; Gaspar, Leticia; Latorre, Borja; Blake, Will; Navas, Ana

    2014-05-01

    Spanish Pyrenean reservoirs are under pressure from high sediment yields in contributing catchments. Sediment fingerprinting approaches offer potential to quantify the contribution of different sediment sources, evaluate catchment erosion dynamics and develop management plans to tackle the reservoir siltation problems. The drainage basin of the Barasona reservoir (1509 km2), located in the Central Spanish Pyrenees, is an alpine-prealpine agroforest basin supplying sediments to the reservoir at an annual rate of around 350 t km-2 with implications for reservoir longevity. The climate is mountain type, wet and cold, with both Atlantic and Mediterranean influences. Steep slopes and the presence of deep and narrow gorges favour rapid runoff and large floods. The ability of geochemical fingerprint properties to discriminate between the sediment sources was investigated by conducting the nonparametric Kruskal-Wallis H-test and a stepwise discriminant function analysis (minimization of Wilk's lambda). This standard procedure selects potential fingerprinting properties as optimum composite fingerprint to characterize and discriminate between sediment sources to the reservoir. Then the contribution of each potential sediment source was assessed by applying a Monte Carlo mixing model to obtain source proportions for the Barasona reservoir sediment samples. The Monte Carlo mixing model was written in C programming language and designed to deliver a user-defined number possible solutions. A Combinatorial Principals method was used to identify the most probable solution with associated uncertainty based on source variability. The unique solution for each sample was characterized by the mean value and the standard deviation of the generated solutions and the lower goodness of fit value applied. This method is argued to guarantee a similar set of representative solutions in all unmixing cases based on likelihood of occurrence. Soil samples for the different potential sediment

  18. Representing Color Ensembles.

    Science.gov (United States)

    Chetverikov, Andrey; Campana, Gianluca; Kristjánsson, Árni

    2017-10-01

    Colors are rarely uniform, yet little is known about how people represent color distributions. We introduce a new method for studying color ensembles based on intertrial learning in visual search. Participants looked for an oddly colored diamond among diamonds with colors taken from either uniform or Gaussian color distributions. On test trials, the targets had various distances in feature space from the mean of the preceding distractor color distribution. Targets on test trials therefore served as probes into probabilistic representations of distractor colors. Test-trial response times revealed a striking similarity between the physical distribution of colors and their internal representations. The results demonstrate that the visual system represents color ensembles in a more detailed way than previously thought, coding not only mean and variance but, most surprisingly, the actual shape (uniform or Gaussian) of the distribution of colors in the environment.

  19. Modeling the economic outcomes of immuno-oncology drugs: alternative model frameworks to capture clinical outcomes

    Directory of Open Access Journals (Sweden)

    Gibson EJ

    2018-03-01

    Full Text Available EJ Gibson,1 N Begum,1 I Koblbauer,1 G Dranitsaris,2 D Liew,3 P McEwan,4 AA Tahami Monfared,5,6 Y Yuan,7 A Juarez-Garcia,7 D Tyas,8 M Lees9 1Wickenstones Ltd, Didcot, UK; 2Augmentium Pharma Consulting Inc, Toronto, ON, Canada; 3Department of Epidemiology and Preventive Medicine, Alfred Hospital, Monash University, Melbourne, VIC, Australia; 4Health Economics and Outcomes Research Ltd, Cardiff, UK; 5Bristol-Myers Squibb Canada, Saint-Laurent, QC Canada; 6Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada; 7Bristol-Myers Squibb, Princeton, NJ, USA; 8Bristol-Myers Squibb, Uxbridge, UK; 9Bristol-Myers Squibb, Rueil-Malmaison, France Background: Economic models in oncology are commonly based on the three-state partitioned survival model (PSM distinguishing between progression-free and progressive states. However, the heterogeneity of responses observed in immuno-oncology (I-O suggests that new approaches may be appropriate to reflect disease dynamics meaningfully. Materials and methods: This study explored the impact of incorporating immune-specific health states into economic models of I-O therapy. Two variants of the PSM and a Markov model were populated with data from one clinical trial in metastatic melanoma patients. Short-term modeled outcomes were benchmarked to the clinical trial data and a lifetime model horizon provided estimates of life years and quality adjusted life years (QALYs. Results: The PSM-based models produced short-term outcomes closely matching the trial outcomes. Adding health states generated increased QALYs while providing a more granular representation of outcomes for decision making. The Markov model gave the greatest level of detail on outcomes but gave short-term results which diverged from those of the trial (overstating year 1 progression-free survival by around 60%. Conclusion: Increased sophistication in the representation of disease dynamics in economic models

  20. Organising nursing practice into care models that catalyse quality: A clinical nurse leader case study.

    Science.gov (United States)

    Bender, Miriam; Spiva, LeeAnna; Su, Wei; Hites, Lisle

    2018-02-09

    To determine the power of a conceptual clinical nurse leader practice model to explain the care model's enactment and trajectory in real world settings. How nursing, organised into specific models of care, functions as an organisational strategy for quality is not well specified. Clinical nurse leader integrated care delivery is one emerging model with growing adoption. A recently validated clinical nurse leader practice model conceptualizes the care model's characteristics and hypothesizes their mechanisms of action. Pattern matching case study design and mixed methods were used to determine how the care model's constructs were operationalized in one regional United States health system that integrated clinical nurse leaders into their care delivery system in 2010. The findings confirmed the empirical presence of all clinical nurse leader practice model constructs and provided a rich description of how the health system operationalized the constructs in practice. The findings support the hypothesized model pathway from Clinical Nurse Leader structuring to Clinical Nurse Leader practice and outcomes. The findings indicate analytic generalizability of the clinical nurse leader practice model. Nursing practice organised to focus on microsystem care processes can catalyse multidisciplinary engagement with, and consistent enactment of, quality practices. The model has great potential for transferability across diverse health systems. © 2018 John Wiley & Sons Ltd.

  1. Author: MA du Plessis CLINICAL LEGAL EDUCATION MODELS ...

    African Journals Online (AJOL)

    21892687

    http://www.nuigalway.ie/business-public-policy-law/school-of-law/students/cle/. .... ...clinical legal education of final year LLB students, with the focus on analytical ..... Spot tests and minute papers can be applied successfully during student ...

  2. The Clinical Learning Spiral: A Model to Develop Reflective Practitioners.

    Science.gov (United States)

    Stockhausen, Lynette

    1994-01-01

    The Clinical Learning Spiral incorporates reflective processes into undergraduate nursing education. It entails successive cycles of four phases: preparative (briefing, planning), constructive (practice development), reflective (debriefing), and reconstructive (planning for change and commitment to action). (SK)

  3. Modeling Staphylococcus epidermidis-Induced Non-Unions: Subclinical and Clinical Evidence in Rats.

    Directory of Open Access Journals (Sweden)

    Arianna Barbara Lovati

    Full Text Available S. epidermidis is one of the leading causes of orthopaedic infections associated with biofilm formation on implant devices. Open fractures are at risk of S. epidermidis transcutaneous contamination leading to higher non-union development compared to closed fractures. Although the role of infection in delaying fracture healing is well recognized, no in vivo models investigated the impact of subclinical low-grade infections on bone repair and non-union. We hypothesized that the non-union rate is directly related to the load of this commonly retrieved pathogen and that a low-grade contamination delays the fracture healing without clinically detectable infection. Rat femurs were osteotomized and stabilized with plates. Fractures were infected with a characterized clinical-derived methicillin-resistant S. epidermidis (10(3, 10(5, 10(8 colony forming units and compared to uninfected controls. After 56 days, bone healing and osteomyelitis were clinically assessed and further evaluated by micro-CT, microbiological and histological analyses. The biofilm formation was visualized by scanning electron microscopy. The control group showed no signs of infection and a complete bone healing. The 10(3 group displayed variable response to infection with a 67% of altered bone healing and positive bacterial cultures, despite no clinical signs of infection present. The 10(5 and 10(8 groups showed severe signs of osteomyelitis and a non-union rate of 83-100%, respectively. The cortical bone reaction related to the periosteal elevation in the control group and the metal scattering detected by micro-CT represented limitations of this study. Our model showed that an intra-operative low-grade S. epidermidis contamination might prevent the bone healing, even in the absence of infectious signs. Our findings also pointed out a dose-dependent effect between the S. epidermidis inoculum and non-union rate. This pilot study identifies a relevant preclinical model to assess the

  4. OSMOSE experiment representativity studies.

    Energy Technology Data Exchange (ETDEWEB)

    Aliberti, G.; Klann, R.; Nuclear Engineering Division

    2007-10-10

    The OSMOSE program aims at improving the neutronic predictions of advanced nuclear fuels through measurements in the MINERVE facility at the CEA-Cadarache (France) on samples containing the following separated actinides: Th-232, U-233, U-234, U-235, U-236, U-238, Np-237, Pu-238, Pu-239, Pu-240, Pu-241, Pu-242, Am-241, Am-243, Cm-244 and Cm-245. The goal of the experimental measurements is to produce a database of reactivity-worth measurements in different neutron spectra for the separated heavy nuclides. This database can then be used as a benchmark for integral reactivity-worth measurements to verify and validate reactor analysis codes and integral cross-section values for the isotopes tested. In particular, the OSMOSE experimental program will produce very accurate sample reactivity-worth measurements for a series of actinides in various spectra, from very thermalized to very fast. The objective of the analytical program is to make use of the experimental data to establish deficiencies in the basic nuclear data libraries, identify their origins, and provide guidelines for nuclear data improvements in coordination with international programs. To achieve the proposed goals, seven different neutron spectra can be created in the MINERVE facility: UO2 dissolved in water (representative of over-moderated LWR systems), UO2 matrix in water (representative of LWRs), a mixed oxide fuel matrix, two thermal spectra containing large epithermal components (representative of under-moderated reactors), a moderated fast spectrum (representative of fast reactors which have some slowing down in moderators such as lead-bismuth or sodium), and a very hard spectrum (representative of fast reactors with little moderation from reactor coolant). The different spectra are achieved by changing the experimental lattice within the MINERVE reactor. The experimental lattice is the replaceable central part of MINERVE, which establishes the spectrum at the sample location. This configuration

  5. Representing distance, consuming distance

    DEFF Research Database (Denmark)

    Larsen, Gunvor Riber

    Title: Representing Distance, Consuming Distance Abstract: Distance is a condition for corporeal and virtual mobilities, for desired and actual travel, but yet it has received relatively little attention as a theoretical entity in its own right. Understandings of and assumptions about distance...... are being consumed in the contemporary society, in the same way as places, media, cultures and status are being consumed (Urry 1995, Featherstone 2007). An exploration of distance and its representations through contemporary consumption theory could expose what role distance plays in forming...

  6. Modeling framework for representing long-term effectiveness of best management practices in addressing hydrology and water quality problems: Framework development and demonstraton using a Bayesian method

    Science.gov (United States)

    Best management practices (BMPs) are popular approaches used to improve hydrology and water quality. Uncertainties in BMP effectiveness over time may result in overestimating long-term efficiency in watershed planning strategies. To represent varying long-term BMP effectiveness in hydrologic/water q...

  7. Refining and validating a conceptual model of Clinical Nurse Leader integrated care delivery.

    Science.gov (United States)

    Bender, Miriam; Williams, Marjory; Su, Wei; Hites, Lisle

    2017-02-01

    To empirically validate a conceptual model of Clinical Nurse Leader integrated care delivery. There is limited evidence of frontline care delivery models that consistently achieve quality patient outcomes. Clinical Nurse Leader integrated care delivery is a promising nursing model with a growing record of success. However, theoretical clarity is necessary to generate causal evidence of effectiveness. Sequential mixed methods. A preliminary Clinical Nurse Leader practice model was refined and survey items developed to correspond with model domains, using focus groups and a Delphi process with a multi-professional expert panel. The survey was administered in 2015 to clinicians and administrators involved in Clinical Nurse Leader initiatives. Confirmatory factor analysis and structural equation modelling were used to validate the measurement and model structure. Final sample n = 518. The model incorporates 13 components organized into five conceptual domains: 'Readiness for Clinical Nurse Leader integrated care delivery'; 'Structuring Clinical Nurse Leader integrated care delivery'; 'Clinical Nurse Leader Practice: Continuous Clinical Leadership'; 'Outcomes of Clinical Nurse Leader integrated care delivery'; and 'Value'. Sample data had good fit with specified model and two-level measurement structure. All hypothesized pathways were significant, with strong coefficients suggesting good fit between theorized and observed path relationships. The validated model articulates an explanatory pathway of Clinical Nurse Leader integrated care delivery, including Clinical Nurse Leader practices that result in improved care dynamics and patient outcomes. The validated model provides a basis for testing in practice to generate evidence that can be deployed across the healthcare spectrum. © 2016 John Wiley & Sons Ltd.

  8. Intentional Modelling: A Process for Clinical Leadership Development in Mental Health Nursing.

    Science.gov (United States)

    Ennis, Gary; Happell, Brenda; Reid-Searl, Kerry

    2016-05-01

    Clinical leadership is becoming more relevant for nurses, as the positive impact that it can have on the quality of care and outcomes for consumers is better understood and more clearly articulated in the literature. As clinical leadership continues to become more relevant, the need to gain an understanding of how clinical leaders in nursing develop will become increasingly important. While the attributes associated with effective clinical leadership are recognized in current literature there remains a paucity of research on how clinical leaders develop these attributes. This study utilized a grounded theory methodology to generate new insights into the experiences of peer identified clinical leaders in mental health nursing and the process of developing clinical leadership skills. Participants in this study were nurses working in a mental health setting who were identified as clinical leaders by their peers as opposed to identifying them by their role or organizational position. A process of intentional modeling emerged as the substantive theory identified in this study. Intentional modeling was described by participants in this study as a process that enabled them to purposefully identify models that assisted them in developing the characteristics of effective clinical leaders as well as allowing them to model these characteristics to others. Reflection on practice is an important contributor to intentional modelling. Intentional modelling could be developed as a framework for promoting knowledge and skill development in the area of clinical leadership.

  9. Representing AIDS in Comics.

    Science.gov (United States)

    Czerwiec, M K

    2018-02-01

    Matthew P. McAllister wrote: "Comic books can and have contributed positively to the discourse about AIDS: images that encourage true education, understanding and compassion can help cope with a biomedical condition which has more than a biomedical relevance" [1]. With this in mind, I combined a 23-narrator oral history and my personal memoir about an inpatient Chicago AIDS hospital unit in my book, Taking Turns: Stories from HIV/AIDS Care Unit 371. In doing so, I built upon the existing rich history of HIV/AIDS in comics, which this article will briefly describe. Although not a comprehensive review of the intersection of AIDS and comics, the book is a tour through influences that proved useful to me. In addition, in making my book, I faced a distinct ethical issue with regard to representing patient experiences with HIV/AIDS, and I describe here how I addressed it. © 2018 American Medical Association. All Rights Reserved.

  10. Representative of the municipality

    International Nuclear Information System (INIS)

    Castellnou Barcelo, J.

    2007-01-01

    Full text of publication follows. The decommissioning of the Vandellos-I nuclear power plant was a big challenge for the host community of Vandellos i l'Hospitalet de l'Infant and the close-by region. Closing down of the facility resulted in a rise of unemployment and a decrease of municipal income. The public was concerned with three issues: safety, transparency and information about the decommissioning, and economic future. Therefore, from the very beginning, municipal governments entered into negotiations with ENRESA on socio-economic benefits, including local employment in dismantling activities, and other types of financial and non-financial compensation. The ADE business association, i.e. a network of business organisations was created that guided the allotment of work to local firms. To satisfy public demand, local municipalities focused on the triad of safety, dialogue and local development, considered the three 'pillars of trust'. A Municipal Monitoring Commission was created, made up of representatives of affected municipalities, the regional government, the ADE business association, trade unions, the local university, the NPP management and ENRESA to monitor the dismantling process and regularly inform the local public. Items that were handled by this Commission included: - Work process monitoring. - Workers. - Materials Control. - Conventional and radioactive or contaminated waste management. - Emanation waste management (liquid and gas) - Safety (training and accidents). - Surveillance (radiological and environmental: dust, noise). - Effects. - Fulfillment of agreed conditions. A number of communication tools and channels were used, e.g., public information meetings, an information centre, the municipal magazine, the municipal radio station, and meetings with representatives of the local press. Particularly innovative was the idea to ask academics from the University of Tarragona to help with 'translating' technical information into language that could

  11. Clinical implications of alternative TCP models for nonuniform dose distributions

    International Nuclear Information System (INIS)

    Deasy, J. O.

    1995-01-01

    Several tumor control probability (TCP) models for nonuniform dose distributions were compared, including: (a) a logistic/inter-patient-heterogeneity model, (b) a probit/inter-patient-heterogeneity model, (c) a Poisson/radioresistant-strain/identical-patients model, (d) a Poisson/inter-patient-heterogeneity model and (e) a Poisson/intra-tumor- and inter-patient-heterogeneity model. The models were analyzed in terms of the probability of controlling a single tumor voxel (the voxel control probability, or VCP), as a function of voxel volume and dose. Alternatively, the VCP surface can be thought of as the effect of a small cold spot. The models based on the Poisson equation which include inter-patient heterogeneity ((d) and (e)) have VCP surfaces (VCP as a function of dose and volume) which have a threshold 'waterfall' shape: below the waterfall (in dose), VCP is nearly zero. The threshold dose decreases with decreasing voxel volume. However, models (a), (b), and (c) all show a high probability of controlling a voxel (VCP>50%) with very low dose (e.g., 1 Gy) if the voxel is small (smaller than about 10 -3 of the tumor volume). Model (c) does not have the waterfall shape at low volumes due to the assumption of patient uniformity and a neglect of the effect of the clonogens which are more radiosensitive (and more numerous). Models (a) and (b) deviate from the waterfall shape at low volumes due to numerical differences between the functions used and the Poisson function. Hence, the Possion models which include inter-patient heterogeneities ((d) and (e)) are more sensitive to the effects of small cold spots than the other models considered

  12. Modeling Clinic for Industrial Mathematics: A Collaborative Project Under Erasmus+ Program

    DEFF Research Database (Denmark)

    Jurlewicz, Agnieszka; Nunes, Claudia; Russo, Giovanni

    2018-01-01

    Modeling Clinic for Industrial Mathematics (MODCLIM) is a Strategic Partnership for the Development of Training Workshops and Modeling Clinic for Industrial Mathematics, funded through the European Commission under the Erasmus Plus Program, Key Action 2: Cooperation for innovation and the exchang...

  13. Comparison of Nursing Student and Instructor Preferences for Block and Nonblock Clinical Models.

    Science.gov (United States)

    Rohatinsky, Noelle; Chachula, Kathryn; Sedgwick, Monique; Press, Madeline M; Compton, Roslyn M; Lane, Brenda

    2017-10-05

    Clinical experiences are the hallmark of prelicensure nursing programs and assist students with applying nursing theory into practice. The literature is limited with respect to nursing student and instructor preferences for type of clinical model to facilitate student learning. This article explores these perceptions in the nursing programs of 5 universities located in 4 Western Canadian provinces. Findings support the use of both nonblock and block clinical models throughout nursing education programs.

  14. Peer-assisted learning model enhances clinical clerk's procedural skills.

    Science.gov (United States)

    Huang, Chia-Chang; Hsu, Hui-Chi; Yang, Ling-Yu; Chen, Chen-Huan; Yang, Ying-Ying; Chang, Ching-Chih; Chuang, Chiao-Lin; Lee, Wei-Shin; Lee, Fa-Yauh; Hwang, Shinn-Jang

    2018-05-17

    Failure to transfer procedural skills learned in a laboratory to the bedside is commonly due to a lack of peer support/stimulation. A digital platform (Facebook) allows new clinical clerks to share experiences and tips that help augment their procedural skills in a peer-assisted learning/teaching method. This study aims to investigate the effectiveness of the innovation of using the digital platform to support the transfer of laboratory-trained procedural skills in the clinical units. Volunteer clinical clerks (n = 44) were enrolled into the peer-assisted learning (PAL) group, which was characterized by the peer-assisted learning of procedural skills during their final 3-month clinical clerkship block. Other clerks (n = 51) did not join the procedural skills-specific Facebook group and served as the self-directed learning regular group. The participants in both the PAL and regular groups completed pre- and post-intervention self-assessments for general self-assessed efficiency ratings (GSER) and skills specific self-assessed efficiency ratings (SSSER) for performing vein puncture, intravenous (IV) catheter and nasogastric (NG) tube insertion. Finally, all clerks received the post-intervention 3-station Objective Structured Clinical Skills Examination (OSCE) to test their proficiency for the abovementioned three procedural skills. Higher cumulative numbers of vein punctures, IV catheter insertions and NG tube insertions at the bedside were carried out by the PAL group than the regular group. A greater improvement in GSERs and SSSERs for medical procedures was found in the PAL group than in the regular group. The PAL group obtained higher procedural skills scores in the post-intervention OSCEs than the regular group. Our study suggested that the implementation of a procedural skill-specific digital platform effectively helps clerks to transfer laboratory-trained procedural skills into the clinical units. In comparison with the regular self-directed learning

  15. CLINICAL

    African Journals Online (AJOL)

    laborative Study (HPMCS), representing the combined data of 3 941 HIV-infected infants and children ... antibody-positive infants with severe disease before confirmation by HIV DNA polymerase chain .... human immunodeficiency virus infection in children less than 13 years of age. MMWR Morb Mortal Wkly Rep 1994; 43: ...

  16. A factor analytic investigation of the Tripartite model of affect in a clinical sample of young Australians

    Directory of Open Access Journals (Sweden)

    Cosgrave Elizabeth M

    2008-09-01

    Full Text Available Abstract Background The Mood and Anxiety Symptom Questionnaire (MASQ was designed to specifically measure the Tripartite model of affect and is proposed to offer a delineation between the core components of anxiety and depression. Factor analytic data from adult clinical samples has shown mixed results; however no studies employing confirmatory factor analysis (CFA have supported the predicted structure of distinct Depression, Anxiety and General Distress factors. The Tripartite model has not been validated in a clinical sample of older adolescents and young adults. The aim of the present study was to examine the validity of the Tripartite model using scale-level data from the MASQ and correlational and confirmatory factor analysis techniques. Methods 137 young people (M = 17.78, SD = 2.63 referred to a specialist mental health service for adolescents and young adults completed the MASQ and diagnostic interview. Results All MASQ scales were highly inter-correlated, with the lowest correlation between the depression- and anxiety-specific scales (r = .59. This pattern of correlations was observed for all participants rating for an Axis-I disorder but not for participants without a current disorder (r = .18. Confirmatory factor analyses were conducted to evaluate the model fit of a number of solutions. The predicted Tripartite structure was not supported. A 2-factor model demonstrated superior model fit and parsimony compared to 1- or 3-factor models. These broad factors represented Depression and Anxiety and were highly correlated (r = .88. Conclusion The present data lend support to the notion that the Tripartite model does not adequately explain the relationship between anxiety and depression in all clinical populations. Indeed, in the present study this model was found to be inappropriate for a help-seeking community sample of older adolescents and young adults.

  17. Long‐Term Post‐CABG Survival: Performance of Clinical Risk Models Versus Actuarial Predictions

    Science.gov (United States)

    Carr, Brendan M.; Romeiser, Jamie; Ruan, Joyce; Gupta, Sandeep; Seifert, Frank C.; Zhu, Wei

    2015-01-01

    Abstract Background/aim Clinical risk models are commonly used to predict short‐term coronary artery bypass grafting (CABG) mortality but are less commonly used to predict long‐term mortality. The added value of long‐term mortality clinical risk models over traditional actuarial models has not been evaluated. To address this, the predictive performance of a long‐term clinical risk model was compared with that of an actuarial model to identify the clinical variable(s) most responsible for any differences observed. Methods Long‐term mortality for 1028 CABG patients was estimated using the Hannan New York State clinical risk model and an actuarial model (based on age, gender, and race/ethnicity). Vital status was assessed using the Social Security Death Index. Observed/expected (O/E) ratios were calculated, and the models' predictive performances were compared using a nested c‐index approach. Linear regression analyses identified the subgroup of risk factors driving the differences observed. Results Mortality rates were 3%, 9%, and 17% at one‐, three‐, and five years, respectively (median follow‐up: five years). The clinical risk model provided more accurate predictions. Greater divergence between model estimates occurred with increasing long‐term mortality risk, with baseline renal dysfunction identified as a particularly important driver of these differences. Conclusions Long‐term mortality clinical risk models provide enhanced predictive power compared to actuarial models. Using the Hannan risk model, a patient's long‐term mortality risk can be accurately assessed and subgroups of higher‐risk patients can be identified for enhanced follow‐up care. More research appears warranted to refine long‐term CABG clinical risk models. doi: 10.1111/jocs.12665 (J Card Surg 2016;31:23–30) PMID:26543019

  18. Spinal cord stimulation: modeling results and clinical data

    NARCIS (Netherlands)

    Struijk, Johannes J.; Struijk, J.J.; Holsheimer, J.; Barolat, Giancarlo; He, Jiping

    1992-01-01

    The potential distribution in volume couductor models of the spinal cord at cervical, midthoracic and lowthoracic levels, due to epidural stimulation, was calculated. Treshold stimuli of modeled myelhated dorsal column and dorsal root fibers were calculated and were compared with perception

  19. Stakeholder Perceptions, Learning Opportunities, and Student Outcomes in Three Clinical Learning Models.

    Science.gov (United States)

    Hendricks, Susan; DeMeester, Deborah; Stephenson, Evelyn; Welch, Janet

    2016-05-01

    Understanding the strengths and challenges of various clinical models is important for nursing education. Three long-standing clinical models (preceptored, hybrid, and traditional) were compared on several outcome measures related to satisfaction, learning opportunities, and student outcomes. Students, faculty, and preceptors participated in this study. Although no differences were noted in satisfaction or standardized examination scores, students in the preceptored clinical model were able to practice more psychomotor skills. Although participants in the preceptored model reported spending more time communicating with staff nurses than did those in the other models, students in the traditional model spent more time with faculty. No differences were noted among groups in student clinical observation time. All clinical learning models were focused on how clinical time was structured, without an emphasis on how faculty and preceptors work with students to develop nursing clinical reasoning skills. Identifying methodology to impact thinking in the clinical environment is a key next step. [J Nurs Educ. 2016;55(5):271-277.]. Copyright 2016, SLACK Incorporated.

  20. Modelling and performance analysis of clinical pathways using the stochastic process algebra PEPA.

    Science.gov (United States)

    Yang, Xian; Han, Rui; Guo, Yike; Bradley, Jeremy; Cox, Benita; Dickinson, Robert; Kitney, Richard

    2012-01-01

    Hospitals nowadays have to serve numerous patients with limited medical staff and equipment while maintaining healthcare quality. Clinical pathway informatics is regarded as an efficient way to solve a series of hospital challenges. To date, conventional research lacks a mathematical model to describe clinical pathways. Existing vague descriptions cannot fully capture the complexities accurately in clinical pathways and hinders the effective management and further optimization of clinical pathways. Given this motivation, this paper presents a clinical pathway management platform, the Imperial Clinical Pathway Analyzer (ICPA). By extending the stochastic model performance evaluation process algebra (PEPA), ICPA introduces a clinical-pathway-specific model: clinical pathway PEPA (CPP). ICPA can simulate stochastic behaviours of a clinical pathway by extracting information from public clinical databases and other related documents using CPP. Thus, the performance of this clinical pathway, including its throughput, resource utilisation and passage time can be quantitatively analysed. A typical clinical pathway on stroke extracted from a UK hospital is used to illustrate the effectiveness of ICPA. Three application scenarios are tested using ICPA: 1) redundant resources are identified and removed, thus the number of patients being served is maintained with less cost; 2) the patient passage time is estimated, providing the likelihood that patients can leave hospital within a specific period; 3) the maximum number of input patients are found, helping hospitals to decide whether they can serve more patients with the existing resource allocation. ICPA is an effective platform for clinical pathway management: 1) ICPA can describe a variety of components (state, activity, resource and constraints) in a clinical pathway, thus facilitating the proper understanding of complexities involved in it; 2) ICPA supports the performance analysis of clinical pathway, thereby assisting

  1. Effects of ray profile modeling on resolution recovery in clinical CT

    International Nuclear Information System (INIS)

    Hofmann, Christian; Knaup, Michael; Kachelrieß, Marc

    2014-01-01

    Purpose: Iterative image reconstruction gains more and more interest in clinical routine, as it promises to reduce image noise (and thereby patient dose), to reduce artifacts, or to improve spatial resolution. However, among vendors and researchers, there is no consensus of how to best achieve these goals. The authors are focusing on the aspect of geometric ray profile modeling, which is realized by some algorithms, while others model the ray as a straight line. The authors incorporate ray-modeling (RM) in nonregularized iterative reconstruction. That means, instead of using one simple single needle beam to represent the x-ray, the authors evaluate the double integral of attenuation path length over the finite source distribution and the finite detector element size in the numerical forward projection. Our investigations aim at analyzing the resolution recovery (RR) effects of RM. Resolution recovery means that frequencies can be recovered beyond the resolution limit of the imaging system. In order to evaluate, whether clinical CT images can benefit from modeling the geometrical properties of each x-ray, the authors performed a 2D simulation study of a clinical CT fan-beam geometry that includes the precise modeling of these geometrical properties. Methods: All simulations and reconstructions are performed in native fan-beam geometry. A water phantom with resolution bar patterns and a Forbild thorax phantom with circular resolution patterns representing calcifications in the heart region are simulated. An FBP reconstruction with a Ram–Lak kernel is used as a reference reconstruction. The FBP is compared to iterative reconstruction techniques with and without RM: An ordered subsets convex (OSC) algorithm without any RM (OSC), an OSC where the forward projection is modeled concerning the finite focal spot and detector size (OSC-RM) and an OSC with RM and with a matched forward and backprojection pair (OSC-T-RM, T for transpose). In all cases, noise was matched to

  2. Increasing the spatial scale of process-based agricultural systems models by representing heterogeneity: The case of urine patches in grazed pastures

    DEFF Research Database (Denmark)

    Snow, Val O.; Cichota, R; McAuliffe, John

    2017-01-01

    -paddock simulation. It explicitly preserves the soil carbon and nitrogen heterogeneity but does not require independent simulation of soil water and plant processes and is temporal in that the patches of heterogeneity can appear and disappear during the simulation. The approach was tested through comparison...... to simulations that more-closely represented field conditions and which contained independent urine patches. The testing was successful, reducing substantial error in the simulation of pasture grazed and leaching for modest increases in simulation execution time but we recommend additional testing under very low...

  3. Skew-t partially linear mixed-effects models for AIDS clinical studies.

    Science.gov (United States)

    Lu, Tao

    2016-01-01

    We propose partially linear mixed-effects models with asymmetry and missingness to investigate the relationship between two biomarkers in clinical studies. The proposed models take into account irregular time effects commonly observed in clinical studies under a semiparametric model framework. In addition, commonly assumed symmetric distributions for model errors are substituted by asymmetric distribution to account for skewness. Further, informative missing data mechanism is accounted for. A Bayesian approach is developed to perform parameter estimation simultaneously. The proposed model and method are applied to an AIDS dataset and comparisons with alternative models are performed.

  4. Complement inhibition in pre-clinical models of periodontitis and prospects for clinical application.

    Science.gov (United States)

    Hajishengallis, George; Hajishengallis, Evlambia; Kajikawa, Tetsuhiro; Wang, Baomei; Yancopoulou, Despina; Ricklin, Daniel; Lambris, John D

    2016-06-01

    Periodontitis is a dysbiotic inflammatory disease leading to the destruction of the tooth-supporting tissues. Current therapies are not always effective and this prevalent oral disease continues to be a significant health and economic burden. Early clinical studies have associated periodontitis with elevated complement activity. Consistently, subsequent genetic and pharmacological studies in rodents have implicated the central complement component C3 and downstream signaling pathways in periodontal host-microbe interactions that promote dysbiosis and inflammatory bone loss. This review discusses these mechanistic advances and moreover focuses on the compstatin family of C3 inhibitors as a novel approach to treat periodontitis. In this regard, local application of the current lead analog Cp40 was recently shown to block both inducible and naturally occurring periodontitis in non-human primates. These promising results from non-human primate studies and the parallel development of Cp40 for clinical use highlight the feasibility for developing an adjunctive, C3-targeted therapy for human periodontitis. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. A Representation for Gaining Insight into Clinical Decision Models

    Science.gov (United States)

    Jimison, Holly B.

    1988-01-01

    For many medical domains uncertainty and patient preferences are important components of decision making. Decision theory is useful as a representation for such medical models in computer decision aids, but the methodology has typically had poor performance in the areas of explanation and user interface. The additional representation of probabilities and utilities as random variables serves to provide a framework for graphical and text insight into complicated decision models. The approach allows for efficient customization of a generic model that describes the general patient population of interest to a patient- specific model. Monte Carlo simulation is used to calculate the expected value of information and sensitivity for each model variable, thus providing a metric for deciding what to emphasize in the graphics and text summary. The computer-generated explanation includes variables that are sensitive with respect to the decision or that deviate significantly from what is typically observed. These techniques serve to keep the assessment and explanation of the patient's decision model concise, allowing the user to focus on the most important aspects for that patient.

  6. An integrated model of clinical reasoning: dual-process theory of cognition and metacognition.

    Science.gov (United States)

    Marcum, James A

    2012-10-01

    Clinical reasoning is an important component for providing quality medical care. The aim of the present paper is to develop a model of clinical reasoning that integrates both the non-analytic and analytic processes of cognition, along with metacognition. The dual-process theory of cognition (system 1 non-analytic and system 2 analytic processes) and the metacognition theory are used to develop an integrated model of clinical reasoning. In the proposed model, clinical reasoning begins with system 1 processes in which the clinician assesses a patient's presenting symptoms, as well as other clinical evidence, to arrive at a differential diagnosis. Additional clinical evidence, if necessary, is acquired and analysed utilizing system 2 processes to assess the differential diagnosis, until a clinical decision is made diagnosing the patient's illness and then how best to proceed therapeutically. Importantly, the outcome of these processes feeds back, in terms of metacognition's monitoring function, either to reinforce or to alter cognitive processes, which, in turn, enhances synergistically the clinician's ability to reason quickly and accurately in future consultations. The proposed integrated model has distinct advantages over other models proposed in the literature for explicating clinical reasoning. Moreover, it has important implications for addressing the paradoxical relationship between experience and expertise, as well as for designing a curriculum to teach clinical reasoning skills. © 2012 Blackwell Publishing Ltd.

  7. Identifying appropriate reference data models for comparative effectiveness research (CER) studies based on data from clinical information systems.

    Science.gov (United States)

    Ogunyemi, Omolola I; Meeker, Daniella; Kim, Hyeon-Eui; Ashish, Naveen; Farzaneh, Seena; Boxwala, Aziz

    2013-08-01

    The need for a common format for electronic exchange of clinical data prompted federal endorsement of applicable standards. However, despite obvious similarities, a consensus standard has not yet been selected in the comparative effectiveness research (CER) community. Using qualitative metrics for data retrieval and information loss across a variety of CER topic areas, we compare several existing models from a representative sample of organizations associated with clinical research: the Observational Medical Outcomes Partnership (OMOP), Biomedical Research Integrated Domain Group, the Clinical Data Interchange Standards Consortium, and the US Food and Drug Administration. While the models examined captured a majority of the data elements that are useful for CER studies, data elements related to insurance benefit design and plans were most detailed in OMOP's CDM version 4.0. Standardized vocabularies that facilitate semantic interoperability were included in the OMOP and US Food and Drug Administration Mini-Sentinel data models, but are left to the discretion of the end-user in Biomedical Research Integrated Domain Group and Analysis Data Model, limiting reuse opportunities. Among the challenges we encountered was the need to model data specific to a local setting. This was handled by extending the standard data models. We found that the Common Data Model from the OMOP met the broadest complement of CER objectives. Minimal information loss occurred in mapping data from institution-specific data warehouses onto the data models from the standards we assessed. However, to support certain scenarios, we found a need to enhance existing data dictionaries with local, institution-specific information.

  8. Why Don’t More Farmers Go Organic? Using A Stakeholder-Informed Exploratory Agent-Based Model to Represent the Dynamics of Farming Practices in the Philippines

    Directory of Open Access Journals (Sweden)

    Laura Schmitt Olabisi

    2015-10-01

    Full Text Available In spite of a growing interest in organic agriculture; there has been relatively little research on why farmers might choose to adopt organic methods, particularly in the developing world. To address this shortcoming, we developed an exploratory agent-based model depicting Philippine smallholder farmer decisions to implement organic techniques in rice paddy systems. Our modeling exercise was novel in its combination of three characteristics: first, agent rules were based on focus group data collected in the system of study. Second, a social network structure was built into the model. Third, we utilized variance-based sensitivity analysis to quantify model outcome variability, identify influential drivers, and suggest ways in which further modeling efforts could be focused and simplified. The model results indicated an upper limit on the number of farmers adopting organic methods. The speed of information spread through the social network; crop yields; and the size of a farmer’s plot were highly influential in determining agents’ adoption rates. The results of this stylized model indicate that rates of organic farming adoption are highly sensitive to the yield drop after switchover to organic techniques, and to the speed of information spread through existing social networks. Further research and model development should focus on these system characteristics.

  9. Non-Clinical Models for Neurodegenerative Diseases: Therapeutic Approach and Drug Validation in Animal Models

    Directory of Open Access Journals (Sweden)

    Caridad Ivette Fernandez

    2017-12-01

    Full Text Available In 2016, 19.8% of the Cuban population was aged 60 or over. As a result, age-associated degenerative diseases and other diseases have become priority targets from a prophylactic, diagnostic and therapeutic perspective. As a result, the Cuban biomedical scientific community has addressed its basic, preclinical and epidemiological research in order to rise up to the challenge. A firm step in this direction has been the international congress “State of the art in non-clinical models for neurodegenerative diseases” which has brought together preclinical and clinical researchers, technicians and regulatory staff members from different countries to review the state of the art in neurodegenerations, find unifying ideas, objectives and collaborations or partnership. The objective is to expose the perspectives of new biotechnological products from Cuba and other countries from the diagnostic, therapeutic and neuroprotective point of view. It is crucial, therefore, that the irreplaceable role of laboratory animals in achieving these objectives is understood but they must be used in rational, adequate and ethical manner. We expose the current development trends in this field, being of common interest to the work directed to the search for potential drugs, diagnostic tools and the promotion of changes in lifestyle as a preventive projection.

  10. Modeling the acceptance of clinical information systems among hospital medical staff: an extended TAM model.

    Science.gov (United States)

    Melas, Christos D; Zampetakis, Leonidas A; Dimopoulou, Anastasia; Moustakis, Vassilis

    2011-08-01

    Recent empirical research has utilized the Technology Acceptance Model (TAM) to advance the understanding of doctors' and nurses' technology acceptance in the workplace. However, the majority of the reported studies are either qualitative in nature or use small convenience samples of medical staff. Additionally, in very few studies moderators are either used or assessed despite their importance in TAM based research. The present study focuses on the application of TAM in order to explain the intention to use clinical information systems, in a random sample of 604 medical staff (534 physicians) working in 14 hospitals in Greece. We introduce physicians' specialty as a moderator in TAM and test medical staff's information and communication technology (ICT) knowledge and ICT feature demands, as external variables. The results show that TAM predicts a substantial proportion of the intention to use clinical information systems. Findings make a contribution to the literature by replicating, explaining and advancing the TAM, whereas theory is benefited by the addition of external variables and medical specialty as a moderator. Recommendations for further research are discussed. Copyright © 2011 Elsevier Inc. All rights reserved.

  11. An evaluation of three representative multimedia models used to support cleanup decision-making at hazardous, mixed, and radioactive waste sites

    International Nuclear Information System (INIS)

    Moskowitz, P.D.; Pardi, R.; Fthenakis, V.M.; Holtzman, S.

    1996-01-01

    The decision process involved in cleaning sites contaminated with hazardous, mixed, and radioactive materials is supported often by results obtained from computer models. These results provide limits within which a decision-maker can judge the importance of individual transport and fate processes, and the likely outcome of alternative cleanup strategies. The transport of hazardous materials may occur predominately through one particular pathway but, more often, actual or potential transport must be evaluated across several pathways and media. Multimedia models are designed to simulate the transport of contaminants from a source to a receptor through more than one environmental pathway. Three such multimedia models are reviewed here: MEPAS, MMSOILS, and PRESTO-EPA-CPG. The reviews are based on documentation provided with the software, on published reviews, on personal interviews with the model developers, and on model summaries extracted from computer databases and expert systems. The three models are reviewed within the context of specific media components: air, surface water, ground water, and food chain. Additional sections evaluate the way that these three models calculate human exposure and dose and how they report uncertainty. Special emphasis is placed on how each model handles radionuclide transport within specific media. For the purpose of simulating the transport, fate and effects of radioactive contaminants through more than one pathway, both MEPAS and PRESTO-EPA-CPG are adequate for screening studies; MMSOILS only handles nonradioactive substances and must be modified before it can be used in these same applications. Of the three models, MEPAS is the most versatile, especially if the user needs to model the transport, fate, and effects of hazardous and radioactive contaminants. 44 refs., 2 tabs

  12. Model for investigating the benefits of clinical supervision in psychiatric nursing

    DEFF Research Database (Denmark)

    Gonge, Henrik; Buus, Niels

    2011-01-01

    with the effectiveness of clinical supervision, as measured by the Manchester Clinical Supervision Scale (MCSS). Furthermore, MCSS scores were associated with benefits, such as increased job satisfaction, vitality, rational coping and less stress, emotional exhaustion, and depersonalization. Multivariate analyses......The objective of this study was to test a model for analysing the possible benefits of clinical supervision. The model suggested a pathway from participation to effectiveness to benefits of clinical supervision, and included possible influences of individual and workplace factors. The study sample...

  13. A better way of representing stem area index in two-big-leaf models: the application and impact on canopy integration of leaf nitrogen content

    Science.gov (United States)

    Chen, M.; Butler, E. E.; Wythers, K. R.; Kattge, J.; Ricciuto, D. M.; Thornton, P. E.; Atkin, O. K.; Flores-Moreno, H.; Reich, P. B.

    2017-12-01

    In order to better estimate the carbon budget of the globe, accurately simulating gross primary productivity (GPP) in earth system models is critical. When upscaling leaf level photosynthesis to the canopy, climate models uses different big-leaf schemes. About half of the state-of-the-art earth system models use a "two-big-leaf" scheme that partitions canopies into direct and diffusively illuminated fractions to reduce high bias of GPP simulated by one-big-leaf models. Some two-big-leaf models, such as ACME (identical in this respect to CLM 4.5) add leaf area index (LAI) and stem area index (SAI) together when calculating canopy radiation transfer. This treatment, however, will result in higher fraction of sunlit leaves. It will also lead to an artificial overestimation of canopy nitrogen content. Here we introduce a new algorithm of simulating SAI in a two-big-leaf model. The new algorithm reduced the sunlit leave fraction of the canopy and conserved the nitrogen content from leaf to canopy level. The lower fraction of sunlit leaves reduced global GPP especially in tropical area. Compared to the default model, for the past 100 years (1909-2009), the averaged global annual GPP is lowered by 4.11 PgC year-1 using this new algorithm.

  14. Experimental determination of some equilibrium parameter of Damavand tokamak by magnetic probe measurements for representing a physical model for plasma vertical movement.

    Science.gov (United States)

    Farahani, N Darestani; Davani, F Abbasi

    2015-10-01

    This investigation is about plasma modeling for the control of vertical instabilities in Damavand tokamak. This model is based on online magnetic measurement. The algebraic equation defining the vertical position in this model is based on instantaneous force-balance. Two parameters in this equation, including decay index, n, and lambda, Λ, have been considered as functions of time-varying poloidal field coil currents and plasma current. Then these functions have been used in a code generated for modeling the open loop response of plasma. The main restriction of the suitability analysis of the model is that the experiments always have to be performed in the presence of a control loop for stabilizing vertical position. As a result, open loop response of the system has been identified from closed loop experimental data by nonlinear neural network identification method. The results of comparison of physical model with identified open loop response from closed loop experiments show root mean square error percentage less than 10%. The results are satisfying that the physical model is useful as a Damavand tokamak vertical movement simulator.

  15. Clinical Complexity in Medicine: A Measurement Model of Task and Patient Complexity.

    Science.gov (United States)

    Islam, R; Weir, C; Del Fiol, G

    2016-01-01

    Complexity in medicine needs to be reduced to simple components in a way that is comprehensible to researchers and clinicians. Few studies in the current literature propose a measurement model that addresses both task and patient complexity in medicine. The objective of this paper is to develop an integrated approach to understand and measure clinical complexity by incorporating both task and patient complexity components focusing on the infectious disease domain. The measurement model was adapted and modified for the healthcare domain. Three clinical infectious disease teams were observed, audio-recorded and transcribed. Each team included an infectious diseases expert, one infectious diseases fellow, one physician assistant and one pharmacy resident fellow. The transcripts were parsed and the authors independently coded complexity attributes. This baseline measurement model of clinical complexity was modified in an initial set of coding processes and further validated in a consensus-based iterative process that included several meetings and email discussions by three clinical experts from diverse backgrounds from the Department of Biomedical Informatics at the University of Utah. Inter-rater reliability was calculated using Cohen's kappa. The proposed clinical complexity model consists of two separate components. The first is a clinical task complexity model with 13 clinical complexity-contributing factors and 7 dimensions. The second is the patient complexity model with 11 complexity-contributing factors and 5 dimensions. The measurement model for complexity encompassing both task and patient complexity will be a valuable resource for future researchers and industry to measure and understand complexity in healthcare.

  16. ProvenCare: Geisinger's Model for Care Transformation through Innovative Clinical Initiatives and Value Creation.

    Science.gov (United States)

    2009-04-01

    Geisinger's system of care can be seen as a microcosm of the national delivery of healthcare, with implications for decision makers in other health plans. In this interview, Dr Ronald A. Paulus focuses on Geisinger's unique approach to patient care. In its core, this approach represents a system of quality and value initiatives based on 3 major programs-Proven Health Navigation (medical home); the ProvenCare model; and transitions of care. The goal of such an approach is to optimize disease management by using a rational reimbursement paradigm for appropriate interventions, providing innovative incentives, and engaging patients in their own care as part of any intervention. Dr Paulus explains the reasons why, unlike Geisinger, other stakeholders, including payers, providers, patients, and employers, have no intrinsic reasons to be concerned with quality and value initiatives. In addition, he says, an electronic infrastructure that could be modified as management paradigms evolve is a necessary tool to ensure the healthcare delivery system's ability to adapt to new clinical realities quickly to ensure the continuation of delivering best value for all stakeholders.

  17. The developing cancer stem-cell model: clinical challenges and opportunities.

    Science.gov (United States)

    Vermeulen, Louis; de Sousa e Melo, Felipe; Richel, Dick J; Medema, Jan Paul

    2012-02-01

    During the past decade, a stem-cell-like subset of cancer cells has been identified in many malignancies. These cells, referred to as cancer stem cells (CSCs), are of particular interest because they are believed to be the clonogenic core of the tumour and therefore represent the cell population that drives growth and progression. Many efforts have been made to design therapies that specifically target the CSC population, since this was predicted to be the crucial population to eliminate. However, recent insights have complicated the initial elegant model, by showing a dominant role for the tumour microenvironment in determining CSC characteristics within a malignancy. This is particularly important since dedifferentiation of non-tumorigenic tumour cells towards CSCs can occur, and therefore the CSC population in a neoplasm is expected to vary over time. Moreover, evidence suggests that not all tumours are driven by rare CSCs, but might instead contain a large population of tumorigenic cells. Even though these results suggest that specific targeting of the CSC population might not be a useful therapeutic strategy, research into the hierarchical cellular organisation of malignancies has provided many important new insights in the biology of tumours. In this Personal View, we highlight how the CSC concept is developing and influences our thinking on future treatment for solid tumours, and recommend ways to design clinical trials to assess drugs that target malignant disease in a rational fashion. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Building prognostic models for breast cancer patients using clinical variables and hundreds of gene expression signatures

    Directory of Open Access Journals (Sweden)

    Liu Yufeng

    2011-01-01

    Full Text Available Abstract Background Multiple breast cancer gene expression profiles have been developed that appear to provide similar abilities to predict outcome and may outperform clinical-pathologic criteria; however, the extent to which seemingly disparate profiles provide additive prognostic information is not known, nor do we know whether prognostic profiles perform equally across clinically defined breast cancer subtypes. We evaluated whether combining the prognostic powers of standard breast cancer clinical variables with a large set of gene expression signatures could improve on our ability to predict patient outcomes. Methods Using clinical-pathological variables and a collection of 323 gene expression "modules", including 115 previously published signatures, we build multivariate Cox proportional hazards models using a dataset of 550 node-negative systemically untreated breast cancer patients. Models predictive of pathological complete response (pCR to neoadjuvant chemotherapy were also built using this approach. Results We identified statistically significant prognostic models for relapse-free survival (RFS at 7 years for the entire population, and for the subgroups of patients with ER-positive, or Luminal tumors. Furthermore, we found that combined models that included both clinical and genomic parameters improved prognostication compared with models with either clinical or genomic variables alone. Finally, we were able to build statistically significant combined models for pathological complete response (pCR predictions for the entire population. Conclusions Integration of gene expression signatures and clinical-pathological factors is an improved method over either variable type alone. Highly prognostic models could be created when using all patients, and for the subset of patients with lymph node-negative and ER-positive breast cancers. Other variables beyond gene expression and clinical-pathological variables, like gene mutation status or DNA

  19. Development of a representative model of a wind turbine in order to study the installation of several machines on a wind park

    International Nuclear Information System (INIS)

    Jourieh, M.

    2007-12-01

    This thesis is devoted to the study of aerodynamics in wind turbines. It is divided into two main parts, one is experimental, and the other deals with modelling and numerical simulation. The velocity field downstream from a three-bladed wind turbine with a horizontal axis is explored in the wind tunnel at ENSAM-Paris. Two measurement techniques are used: hot wire anemometry and Particle Image Velocimetry (PIV). Experimental work gives a clear idea of the structure of the near wake and provides useful data to validate the numerical simulations and the hybrid models which are studied in this thesis. In the work concerning numerical simulation, two hybrid models are defined and implemented: a model of actuator disc and a model of actuator cylinder, coupled with a simulation based on the numerical resolution of the Navier-Stokes equations. These models are validated by the power of the wind turbine and on the velocity field in the near wake of the rotor. The numerical results are compared with the experimental data resulting from the tests carried out by the NREL for NREL phase II and VI cases. The experimental and numerical velocity fields are also compared in the wake of a wind turbine Rutland 503. In both validation cases, power and wake, the experimental data are in accordance with the results provided by the hybrid models. After this validation, the interaction between several wind turbines is studied and quantified. The tested hybrid models are also used to study the interaction between identical wind turbines placed one behind the other. The obtained results highlight the effect of spacing between the machines as well as the effect of free stream velocity. (author)

  20. Medical students' emotional development in early clinical experience : a model

    NARCIS (Netherlands)

    Helmich, Esther; Bolhuis, Sanneke; Laan, Roland; Dornan, Tim; Koopmans, Raymond

    Dealing with emotions is a critical feature of professional behaviour. There are no comprehensive theoretical models, however, explaining how medical students learn about emotions. We aimed to explore factors affecting their emotions and how they learn to deal with emotions in themselves and others.

  1. Influenza Vaccinations, Fall 2009: Model School-Located Vaccination Clinics

    Science.gov (United States)

    Herl Jenlink, Carolyn; Kuehnert, Paul; Mazyck, Donna

    2010-01-01

    The 2009 H1N1 influenza virus presented a major challenge to health departments, schools, and other community partners to effectively vaccinate large numbers of Americans, primarily children. The use of school-located vaccination (SLV) programs to address this challenge led health departments and schools to become creative in developing models for…

  2. An evaluation of uncertainty in the aerosol optical properties as represented by satellites and an ensemble of chemistry-climate coupled models over Europe

    Science.gov (United States)

    Palacios-Peña, Laura; Baró, Rocío; Jiménez-Guerrero, Pedro

    2016-04-01

    The changes in Earth's climate are produced by forcing agents such as greenhouse gases, clouds and atmospheric aerosols. The latter modify the Earth's radiative budget due to their optical, microphysical and chemical properties, and are considered to be the most uncertain forcing agent. There are two main approaches to the study of aerosols: (1) ground-based and remote sensing observations and (2) atmospheric modelling. With the aim of characterizing the uncertainties associated with these approaches, and estimating the radiative forcing caused by aerosols, the main objective of this work is to assess the representation of aerosol optical properties by different remote sensing sensors and online-coupled chemistry-climate models and to determine whether the inclusion of aerosol radiative feedbacks in this type of models improves the modelling outputs over Europe. Two case studies have been selected under the framework of the EuMetChem COST Action ES1004, when important aerosol episodes during 2010 over Europe took place: a Russian wildfires episode and a Saharan desert dust outbreak covering most of Europe. Model data comes from an ensemble of regional air quality-climate simulations performed by the working group 2 of EuMetChem, that investigates the importance of different processes and feedbacks in on-line coupled chemistry-climate models. These simulations are run for three different configurations for each model, differing in the inclusion (or not) of aerosol-radiation and aerosol-cloud interactions. The remote sensing data comes from three different sensors, MODIS (Moderate Resolution Imaging Spectroradiometer), OMI (Ozone Monitoring Instrument) and SeaWIFS (Sea-viewing Wide Field-of-view Sensor). The evaluation has been performed by using classical statistical metrics, comparing modelled and remotely sensed data versus a ground-based instrument network (AERONET). The evaluated variables are aerosol optical depth (AOD) and the Angström exponent (AE) at

  3. Assessing Discriminative Performance at External Validation of Clinical Prediction Models.

    Directory of Open Access Journals (Sweden)

    Daan Nieboer

    Full Text Available External validation studies are essential to study the generalizability of prediction models. Recently a permutation test, focusing on discrimination as quantified by the c-statistic, was proposed to judge whether a prediction model is transportable to a new setting. We aimed to evaluate this test and compare it to previously proposed procedures to judge any changes in c-statistic from development to external validation setting.We compared the use of the permutation test to the use of benchmark values of the c-statistic following from a previously proposed framework to judge transportability of a prediction model. In a simulation study we developed a prediction model with logistic regression on a development set and validated them in the validation set. We concentrated on two scenarios: 1 the case-mix was more heterogeneous and predictor effects were weaker in the validation set compared to the development set, and 2 the case-mix was less heterogeneous in the validation set and predictor effects were identical in the validation and development set. Furthermore we illustrated the methods in a case study using 15 datasets of patients suffering from traumatic brain injury.The permutation test indicated that the validation and development set were homogenous in scenario 1 (in almost all simulated samples and heterogeneous in scenario 2 (in 17%-39% of simulated samples. Previously proposed benchmark values of the c-statistic and the standard deviation of the linear predictors correctly pointed at the more heterogeneous case-mix in scenario 1 and the less heterogeneous case-mix in scenario 2.The recently proposed permutation test may provide misleading results when externally validating prediction models in the presence of case-mix differences between the development and validation population. To correctly interpret the c-statistic found at external validation it is crucial to disentangle case-mix differences from incorrect regression coefficients.

  4. Development and Application of an Integrated Model for Representing Hydrologic Processes and Irrigation at Residential Scale in Semiarid and Mediterranean Regions

    Science.gov (United States)

    Herrera, J. B.; Gironas, J. A.; Bonilla, C. A.; Vera, S.; Reyes, F. R.

    2015-12-01

    Urbanization alters physical and biological processes that take place in natural environments. New impervious areas change the hydrological processes, reducing infiltration and evapotranspiration and increasing direct runoff volumes and flow discharges. To reduce these effects at local scale, sustainable urban drainage systems, low impact development and best management practices have been developed and implemented. These technologies, which typically consider some type of green infrastructure (GI), simulate natural processes of capture, retention and infiltration to control flow discharges from frequent events and preserve the hydrological cycle. Applying these techniques in semiarid regions requires accounting for aspects related to the maintenance of green areas, such as the irrigation needs and the selection of the vegetation. This study develops the Integrated Hydrological Model at Residential Scale, IHMORS, which is a continuous model that simulates the most relevant hydrological processes together with irrigation processes of green areas. In the model contributing areas and drainage control practices are modeled by combining and connecting differents subareas subjected to surface processes (i.e. interception, evapotranspiration, infiltration and surface runoff) and sub-surface processes (percolation, redistribution and subsurface runoff). The model simulates these processes and accounts for the dynamics of the water content in different soil layers. The different components of the model were first tested using laboratory and numerical experiments, and then an application to a case study was carried out. In this application we assess the long-term performance in terms of runoff control and irrigation needs of green gardens with different vegetation, under different climate and irrigation practices. The model identifies significant differences in the performance of the alternatives and provides a good insight for the maintenance needs of GI for runoff control.

  5. Representing culture in interstellar messages

    Science.gov (United States)

    Vakoch, Douglas A.

    2008-09-01

    As scholars involved with the Search for Extraterrestrial Intelligence (SETI) have contemplated how we might portray humankind in any messages sent to civilizations beyond Earth, one of the challenges they face is adequately representing the diversity of human cultures. For example, in a 2003 workshop in Paris sponsored by the SETI Institute, the International Academy of Astronautics (IAA) SETI Permanent Study Group, the International Society for the Arts, Sciences and Technology (ISAST), and the John Templeton Foundation, a varied group of artists, scientists, and scholars from the humanities considered how to encode notions of altruism in interstellar messages . Though the group represented 10 countries, most were from Europe and North America, leading to the group's recommendation that subsequent discussions on the topic should include more globally representative perspectives. As a result, the IAA Study Group on Interstellar Message Construction and the SETI Institute sponsored a follow-up workshop in Santa Fe, New Mexico, USA in February 2005. The Santa Fe workshop brought together scholars from a range of disciplines including anthropology, archaeology, chemistry, communication science, philosophy, and psychology. Participants included scholars familiar with interstellar message design as well as specialists in cross-cultural research who had participated in the Symposium on Altruism in Cross-cultural Perspective, held just prior to the workshop during the annual conference of the Society for Cross-cultural Research . The workshop included discussion of how cultural understandings of altruism can complement and critique the more biologically based models of altruism proposed for interstellar messages at the 2003 Paris workshop. This paper, written by the chair of both the Paris and Santa Fe workshops, will explore the challenges of communicating concepts of altruism that draw on both biological and cultural models.

  6. Combined field/modelling approaches to represent the air-vegetation distribution of benzo[a]pyrene using different vegetation species

    Science.gov (United States)

    Ratola, Nuno; Jiménez-Guerrero, Pedro

    2015-04-01

    A strategy designed to combine the features of field-based experiments and modelling approaches is presented in this work to assess air-vegetation distribution of benzo(a)pyrene (BaP) in the Iberian Peninsula (IP). Given the lack of simultaneous data in both environmental matrices, a methodology with two main steps was employed. First, evaluating the simulations with the chemistry transport model (CTM) WRF (Weather Research and Forecasting) + CHIMERE data against the European Monitoring and Evaluation Programme (EMEP) network, to test the aptitude of the CTM to replicate the respective atmospheric levels. Then, using modelled concentrations and a method to estimate air levels of BaP from biomonitoring data to compare the performance of different pine species (Pinus pinea, Pinus pinaster, Pinus nigra and Pinus halepensis) to describe the atmospheric evidences. The comparison of modelling vs. biomonitoring has a higher dependence on the location of the sampling points, rather than on the pine species, as some tend to overestimate and others to underestimate BaP concentrations, in most cases regardless of the season. The climatology of the canopy levels of BaP was successfully validated with the concentrations in pine needles (most biases below 26%), however, the model was unable to distinguish between species. This should be taken into consideration in future studies, as biases can rise up to 48%, especially in summer and autumn, the. The comparison with biomonitoring data showed a similar pattern, but with the best results in the warmer months.

  7. Predicting inpatient clinical order patterns with probabilistic topic models vs conventional order sets.

    Science.gov (United States)

    Chen, Jonathan H; Goldstein, Mary K; Asch, Steven M; Mackey, Lester; Altman, Russ B

    2017-05-01

    Build probabilistic topic model representations of hospital admissions processes and compare the ability of such models to predict clinical order patterns as compared to preconstructed order sets. The authors evaluated the first 24 hours of structured electronic health record data for > 10 K inpatients. Drawing an analogy between structured items (e.g., clinical orders) to words in a text document, the authors performed latent Dirichlet allocation probabilistic topic modeling. These topic models use initial clinical information to predict clinical orders for a separate validation set of > 4 K patients. The authors evaluated these topic model-based predictions vs existing human-authored order sets by area under the receiver operating characteristic curve, precision, and recall for subsequent clinical orders. Existing order sets predict clinical orders used within 24 hours with area under the receiver operating characteristic curve 0.81, precision 16%, and recall 35%. This can be improved to 0.90, 24%, and 47% ( P  sets tend to provide nonspecific, process-oriented aid, with usability limitations impairing more precise, patient-focused support. Algorithmic summarization has the potential to breach this usability barrier by automatically inferring patient context, but with potential tradeoffs in interpretability. Probabilistic topic modeling provides an automated approach to detect thematic trends in patient care and generate decision support content. A potential use case finds related clinical orders for decision support. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association.

  8. A formal statistical approach to representing uncertainty in rainfall-runoff modelling with focus on residual analysis and probabilistic output evaluation - Distinguishing simulation and prediction

    DEFF Research Database (Denmark)

    Breinholt, Anders; Møller, Jan Kloppenborg; Madsen, Henrik

    2012-01-01

    While there seems to be consensus that hydrological model outputs should be accompanied with an uncertainty estimate the appropriate method for uncertainty estimation is not agreed upon and a debate is ongoing between advocators of formal statistical methods who consider errors as stochastic...... and GLUE advocators who consider errors as epistemic, arguing that the basis of formal statistical approaches that requires the residuals to be stationary and conform to a statistical distribution is unrealistic. In this paper we take a formal frequentist approach to parameter estimation and uncertainty...... necessary but the statistical assumptions were nevertheless not 100% justified. The residual analysis showed that significant autocorrelation was present for all simulation models. We believe users of formal approaches to uncertainty evaluation within hydrology and within environmental modelling in general...

  9. A study of V79 cell survival after for proton and carbon ion beams as represented by the parameters of Katz' track structure model

    DEFF Research Database (Denmark)

    Grzanka, Leszek; Waligórski, M. P. R.; Bassler, Niels

    different sets of data obtained for the same cell line and different ions, measured at different laboratories, we have fitted model parameters to a set of carbon-irradiated V79 cells, published by Furusawa et al. (2), and to a set of proton-irradiated V79 cells, published by Wouters et al. (3), separately....... We found that values of model parameters best fitted to the carbon data of Furusawa et al. yielded predictions of V79 survival after proton irradiation which did not match the V79 proton data of Wouters et al. Fitting parameters to both sets combined did not improve the accuracy of model predictions...... carbon irradiation. 1. Katz, R., Track structure in radiobiology and in radiation detection. Nuclear Track Detection 2: 1-28 (1978). 2. Furusawa Y. et al. Inactivation of aerobic and hypoxic cells from three different cell lines by accelerated 3He-, 12C- and 20Ne beams. Radiat Res. 2012 Jan; 177...

  10. Non-point Source Pollution Modeling Using Geographic Information System (GIS for Representing Best Management Practices (BMP in the Gorganrood Watershed

    Directory of Open Access Journals (Sweden)

    Z. Pasandidehfard

    2014-09-01

    Full Text Available The most important pollutants that cause water pollution are nitrogen and phosphorus from agricultural runoff called Non-Point Source Pollution (NPS. To solve this problem, management practices known as BMPs or Best Management Practices are applied. One of the common methods for Non-Point Source Pollution prediction is modeling. By modeling, efficiency of many practices can be tested before application. In this study, land use changes were studied from the years 1984 till 2010 that showed an increase in agricultural lands from 516908.52 to 630737.19 ha and expansion of cities from 5237.87 to 15487.59 ha and roads from 9666.07 to 11430.24 ha. Using L-THIA model (from nonpoint source pollution models for both land use categories, the amount of pollutant and the volume of runoff were calculated that showed high growth. Then, the seventh sub-basin was recognized as a critical zone in terms of pollution among the sub-basins. In the end, land use change was considered as a BMP using Multi-Criteria Evaluation (MCE based on which a more suitable land use map was produced. After producing the new land use map, L-THIA model was run again and the result of the model was compared to the actual land use to show the effect of this BMP. Runoff volume decreased from 367.5 to 308.6 M3/ha and nitrogen in runoff was reduced from 3.26 to 1.58 mg/L and water BOD from 3.61 to 2.13 mg/L. Other pollutants also showed high reduction. In the end, land use change is confirmed as an effective BMP for Non-Point Source Pollution reduction.

  11. Reconsidering Clinical Staging Model: A Case of Genetic High Risk for Schizophrenia

    OpenAIRE

    Lee, Tae Young; Kim, Minah; Kim, Sung Nyun; Kwon, Jun Soo

    2016-01-01

    The clinical staging model is considered a useful and practical method not only in dealing with the early stage of psychosis overcoming the debate about diagnostic boundaries but also in emerging mood disorder. However, its one limitation is that it cannot discriminate the heterogeneity of individuals at clinical high risk for psychosis, but lumps them all together. Even a healthy offspring of schizophrenia can eventually show clinical symptoms and progress to schizophrenia under the influenc...

  12. Building trust and diversity in patient-centered oncology clinical trials: An integrated model.

    Science.gov (United States)

    Hurd, Thelma C; Kaplan, Charles D; Cook, Elise D; Chilton, Janice A; Lytton, Jay S; Hawk, Ernest T; Jones, Lovell A

    2017-04-01

    Trust is the cornerstone of clinical trial recruitment and retention. Efforts to decrease barriers and increase clinical trial participation among diverse populations have yielded modest results. There is an urgent need to better understand the complex interactions between trust and clinical trial participation. The process of trust-building has been a focus of intense research in the business community. Yet, little has been published about trust in oncology clinical trials or the process of building trust in clinical trials. Both clinical trials and business share common dimensions. Business strategies for building trust may be transferable to the clinical trial setting. This study was conducted to understand and utilize contemporary thinking about building trust to develop an Integrated Model of Trust that incorporates both clinical and business perspectives. A key word-directed literature search of the PubMed, Medline, Cochrane, and Google Search databases for entries dated between 1 January 1985 and 1 September 2015 was conducted to obtain information from which to develop an Integrated Model of Trust. Successful trial participation requires both participants and clinical trial team members to build distinctly different types of interpersonal trust to effect recruitment and retention. They are built under conditions of significant emotional stress and time constraints among people who do not know each other and have never worked together before. Swift Trust and Traditional Trust are sequentially built during the clinical trial process. Swift trust operates during the recruitment and very early active treatment phases of the clinical trial process. Traditional trust is built over time and operates during the active treatment and surveillance stages of clinical trials. The Psychological Contract frames the participants' and clinical trial team members' interpersonal trust relationship. The "terms" of interpersonal trust are negotiated through the psychological

  13. Representing the root water uptake process in the Common Land Model for better simulating the energy and water vapour fluxes in a Central Asian desert ecosystem

    NARCIS (Netherlands)

    Li, Longhui; van der Tol, C.; Chen, Xuelong; Jing, C.; Su, Zhongbo; Luo, G.; Tian, Xin

    2013-01-01

    The ability of roots to take up water depends on both root distribution and root water uptake efficiency. The former can be experimentally measured, while the latter is extremely difficult to determine. Yet a correct representation of root water uptake process in land surface models (LSMs) is

  14. A methodology for eliciting, representing, and analysing stakeholder knowledge for decision making on complex socio-ecological systems: From cognitive maps to agent-based models

    NARCIS (Netherlands)

    El-Sawah, Sondoss; Guillaume, Joseph H.A.; Filatova, Tatiana; Rook, Josefine; Jakeman, Anthony J.

    2015-01-01

    This paper aims to contribute to developing better ways for incorporating essential human elements in decision making processes for modelling of complex socio-ecological systems. It presents a step-wise methodology for integrating perceptions of stakeholders (qualitative) into formal simulation

  15. Predicting Student Grade Point Average at a Community College from Scholastic Aptitude Tests and from Measures Representing Three Constructs in Vroom's Expectancy Theory Model of Motivation.

    Science.gov (United States)

    Malloch, Douglas C.; Michael, William B.

    1981-01-01

    This study was designed to determine whether an unweighted linear combination of community college students' scores on standardized achievement tests and a measure of motivational constructs derived from Vroom's expectance theory model of motivation was predictive of academic success (grade point average earned during one quarter of an academic…

  16. Human eye modelling for ophthalmic simulators project for clinic applications

    International Nuclear Information System (INIS)

    Sanchez, Andrea; Santos, Adimir dos; Yoriyaz, Helio

    2002-01-01

    Most of eye tumors are treated by surgical means, which involves the enucleation of affected eyes. In terms of treatment and control of diseases, there is brachytherapy, which often utilizes small applicator of Co-60, I-125, Ru-106, Ir-192, etc. These methods are shown to be very efficient but highly cost. The objective of this work is propose a detailed simulator modelling for eye characterization. Additionally, this study can contribute to design and build a new applicator in order to reduce the cost and to allow more patients to be treated

  17. Mouse genetic model for clinical and immunological heterogeneity of leishmaniasis

    Czech Academy of Sciences Publication Activity Database

    Lipoldová, Marie; Svobodová, M.; Havelková, Helena; Krulová, Magdalena; Badalová, Jana; Nohýnková, E.; Hart, A. A. M.; Schlegel, David; Volf, P.; Demant, P.

    2002-01-01

    Roč. 54, č. 3 (2002), s. 174-183 ISSN 0093-7711 R&D Projects: GA MZd NM28; GA ČR GA310/00/0760; GA MŠk OK 394 Grant - others:Howard Hughes Medical Institute(US) HHMI55000323; WHO(XX) TDR I.D. 970772; EC(XE) ERBI-C15-CT98-0317; EC(XE) BIO-4-CT98-0445 Institutional research plan: CEZ:AV0Z5052915 Keywords : Leishmaniasis * mouse model * complex disease Subject RIV: EC - Immunology Impact factor: 2.475, year: 2002

  18. Design and validation of realistic breast models for use in multiple alternative forced choice virtual clinical trials.

    Science.gov (United States)

    Elangovan, Premkumar; Mackenzie, Alistair; Dance, David R; Young, Kenneth C; Cooke, Victoria; Wilkinson, Louise; Given-Wilson, Rosalind M; Wallis, Matthew G; Wells, Kevin

    2017-04-07

    A novel method has been developed for generating quasi-realistic voxel phantoms which simulate the compressed breast in mammography and digital breast tomosynthesis (DBT). The models are suitable for use in virtual clinical trials requiring realistic anatomy which use the multiple alternative forced choice (AFC) paradigm and patches from the complete breast image. The breast models are produced by extracting features of breast tissue components from DBT clinical images including skin, adipose and fibro-glandular tissue, blood vessels and Cooper's ligaments. A range of different breast models can then be generated by combining these components. Visual realism was validated using a receiver operating characteristic (ROC) study of patches from simulated images calculated using the breast models and from real patient images. Quantitative analysis was undertaken using fractal dimension and power spectrum analysis. The average areas under the ROC curves for 2D and DBT images were 0.51  ±  0.06 and 0.54  ±  0.09 demonstrating that simulated and real images were statistically indistinguishable by expert breast readers (7 observers); errors represented as one standard error of the mean. The average fractal dimensions (2D, DBT) for real and simulated images were (2.72  ±  0.01, 2.75  ±  0.01) and (2.77  ±  0.03, 2.82  ±  0.04) respectively; errors represented as one standard error of the mean. Excellent agreement was found between power spectrum curves of real and simulated images, with average β values (2D, DBT) of (3.10  ±  0.17, 3.21  ±  0.11) and (3.01  ±  0.32, 3.19  ±  0.07) respectively; errors represented as one standard error of the mean. These results demonstrate that radiological images of these breast models realistically represent the complexity of real breast structures and can be used to simulate patches from mammograms and DBT images that are indistinguishable from

  19. Positron Emission Tomography in clinical research and clinical diagnosis: tracer modelling and radioreceptors

    International Nuclear Information System (INIS)

    Beckers, C.; Goffinet, A.; Bol, A.

    1989-01-01

    Positron emission tomography (PET) allows noninvasive studies of different metabolic pathways in man in a unique way. Human biochemistry can now be studied using physiological tracers like glucose or oxygen; promising investigations are now underway with various neurotransmitters. The aim of this workshop, sponsored by the European Community, has been to convene a group of experts to discuss more deeply the problems related to the study of receptors and energy metabolism, and this particularly in relationship with the compartmental analysis and the modelling of the data. Up to now, these have mostly been accumulated for the brain and heart. Oncology is now a growing field of interest and more applications are certain to arise in the near future. The papers included in this volume summarize the main points discussed during the workshop. (author). refs.; figs.; tabs

  20. Clinical prediction models for bronchopulmonary dysplasia: a systematic review and external validation study

    NARCIS (Netherlands)

    Onland, Wes; Debray, Thomas P.; Laughon, Matthew M.; Miedema, Martijn; Cools, Filip; Askie, Lisa M.; Asselin, Jeanette M.; Calvert, Sandra A.; Courtney, Sherry E.; Dani, Carlo; Durand, David J.; Marlow, Neil; Peacock, Janet L.; Pillow, J. Jane; Soll, Roger F.; Thome, Ulrich H.; Truffert, Patrick; Schreiber, Michael D.; van Reempts, Patrick; Vendettuoli, Valentina; Vento, Giovanni; van Kaam, Anton H.; Moons, Karel G.; Offringa, Martin

    2013-01-01

    Bronchopulmonary dysplasia (BPD) is a common complication of preterm birth. Very different models using clinical parameters at an early postnatal age to predict BPD have been developed with little extensive quantitative validation. The objective of this study is to review and validate clinical

  1. The Development of a Peer Assisted Learning Model for the Clinical Education of Physiotherapy Students

    Science.gov (United States)

    Sevenhuysen, Samantha L.; Nickson, Wendy; Farlie, Melanie K.; Raitman, Lyn; Keating, Jennifer L.; Molloy, Elizabeth; Skinner, Elizabeth; Maloney, Stephen; Haines, Terry P.

    2013-01-01

    Demand for clinical placements in physiotherapy education continues to outstrip supply. Peer assisted learning, in various formats, has been trialled to increase training capacity and facilitate student learning during clinical education. There are no documented examples of measurable or repeatable peer assisted learning models to aid clinicians…

  2. Clinical Education Partnership: A Model for School District and College of Nursing Collaboration

    Science.gov (United States)

    Kreulen, Grace J.; Bednarz, Patricia K.; Wehrwein, Teresa; Davis, James

    2008-01-01

    Collaboration between school districts and universities has potential to increase the level of health services available in schools while providing quality public health clinical nursing placements for universities. This article describes the development, implementation, and evaluation of the Clinical Education Partnership Model (CEPM), a dynamic…

  3. Clinical Supervision in Alcohol and Drug Abuse Counseling: Principles, Models, Methods.

    Science.gov (United States)

    Powell, David J.

    A case is made for professionalism in clinical training as substance abuse counseling becomes a unique field. Part 1, "Principles," includes: (1) "A Historical Review of Supervision"; (2) "A Working Definition of Supervision"; (3) "Leadership Principles for Supervisors" and; (4) "Traits of an Effective Clinical Supervisor." Part 2, "Models,"…

  4. A Four- and Five-Factor Structural Model for Wechsler Tests: Does It Really Matter Clinically?

    Science.gov (United States)

    Schwartz, David M.

    2013-01-01

    The purpose of this commentary is to focus on the clinical utility of the four- and five-factor structural models for the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) and Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV). It provides a discussion of important considerations when evaluating the clinical utility of the…

  5. Rasch-modeling the Portuguese SOCRATES in a clinical sample.

    Science.gov (United States)

    Lopes, Paulo; Prieto, Gerardo; Delgado, Ana R; Gamito, Pedro; Trigo, Hélder

    2010-06-01

    The Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) assesses motivation for treatment in the drug-dependent population. The development of adequate measures of motivation is needed in order to properly understand the role of this construct in rehabilitation. This study probed the psychometric properties of the SOCRATES in the Portuguese population by means of the Rasch Rating Scale Model, which allows the conjoint measurement of items and persons. The participants were 166 substance abusers under treatment for their addiction. Results show that the functioning of the five response categories is not optimal; our re-analysis indicates that a three-category system is the most appropriate one. By using this response category system, both model fit and estimation accuracy are improved. The discussion takes into account other factors such as item format and content in order to make suggestions for the development of better motivation-for-treatment scales. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  6. The Future of Clinical Pharmacy: Developing a Holistic Model

    Directory of Open Access Journals (Sweden)

    Patricia A. Shane

    2013-11-01

    Full Text Available This concept paper discusses the untapped promise of often overlooked humanistic skills to advance the practice of pharmacy. It highlights the seminal work that is, increasingly, integrated into medical and nursing education. The work of these educators and the growing empirical evidence that validates the importance of humanistic skills is raising questions for the future of pharmacy education and practice. To potentiate humanistic professional competencies, e.g., compassion, empathy, and emotional intelligence, how do we develop a more holistic model that integrates reflective and affective skills? There are many historical and current transitions in the profession and practice of pharmacy. If our education model is refocused with an emphasis on pharmacy’s therapeutic roots, the field has the opportunity to play a vital role in improving health outcomes and patient-centered care. Beyond the metrics of treatment effects, achieving greater patient-centeredness will require transformations that improve care processes and invest in patients’ experiences of the treatment and care they receive. Is layering on additional science sufficient to yield better health outcomes if we neglect the power of empathic interactions in the healing process?

  7. High-resolution mutational profiling suggests the genetic validity of glioblastoma patient-derived pre-clinical models.

    Directory of Open Access Journals (Sweden)

    Shawn E Yost

    Full Text Available Recent advances in the ability to efficiently characterize tumor genomes is enabling targeted drug development, which requires rigorous biomarker-based patient selection to increase effectiveness. Consequently, representative DNA biomarkers become equally important in pre-clinical studies. However, it is still unclear how well these markers are maintained between the primary tumor and the patient-derived tumor models. Here, we report the comprehensive identification of somatic coding mutations and copy number aberrations in four glioblastoma (GBM primary tumors and their matched pre-clinical models: serum-free neurospheres, adherent cell cultures, and mouse xenografts. We developed innovative methods to improve the data quality and allow a strict comparison of matched tumor samples. Our analysis identifies known GBM mutations altering PTEN and TP53 genes, and new actionable mutations such as the loss of PIK3R1, and reveals clear patient-to-patient differences. In contrast, for each patient, we do not observe any significant remodeling of the mutational profile between primary to model tumors and the few discrepancies can be attributed to stochastic errors or differences in sample purity. Similarly, we observe ∼96% primary-to-model concordance in copy number calls in the high-cellularity samples. In contrast to previous reports based on gene expression profiles, we do not observe significant differences at the DNA level between in vitro compared to in vivo models. This study suggests, at a remarkable resolution, the genome-wide conservation of a patient's tumor genetics in various pre-clinical models, and therefore supports their use for the development and testing of personalized targeted therapies.

  8. A reduced-order modeling approach to represent subgrid-scale hydrological dynamics for land-surface simulations: application in a polygonal tundra landscape

    Science.gov (United States)

    Pau, G. S. H.; Bisht, G.; Riley, W. J.

    2014-09-01

    Existing land surface models (LSMs) describe physical and biological processes that occur over a wide range of spatial and temporal scales. For example, biogeochemical and hydrological processes responsible for carbon (CO2, CH4) exchanges with the atmosphere range from the molecular scale (pore-scale O2 consumption) to tens of kilometers (vegetation distribution, river networks). Additionally, many processes within LSMs are nonlinearly coupled (e.g., methane production and soil moisture dynamics), and therefore simple linear upscaling techniques can result in large prediction error. In this paper we applied a reduced-order modeling (ROM) technique known as "proper orthogonal decomposition mapping method" that reconstructs temporally resolved fine-resolution solutions based on coarse-resolution solutions. We developed four different methods and applied them to four study sites in a polygonal tundra landscape near Barrow, Alaska. Coupled surface-subsurface isothermal simulations were performed for summer months (June-September) at fine (0.25 m) and coarse (8 m) horizontal resolutions. We used simulation results from three summer seasons (1998-2000) to build ROMs of the 4-D soil moisture field for the study sites individually (single-site) and aggregated (multi-site). The results indicate that the ROM produced a significant computational speedup (> 103) with very small relative approximation error (training the ROM. We also demonstrate that our approach: (1) efficiently corrects for coarse-resolution model bias and (2) can be used for polygonal tundra sites not included in the training data set with relatively good accuracy (< 1.7% relative error), thereby allowing for the possibility of applying these ROMs across a much larger landscape. By coupling the ROMs constructed at different scales together hierarchically, this method has the potential to efficiently increase the resolution of land models for coupled climate simulations to spatial scales consistent with

  9. Convex hull approach for determining rock representative elementary volume for multiple petrophysical parameters using pore-scale imaging and Lattice-Boltzmann modelling

    Science.gov (United States)

    Shah, S. M.; Crawshaw, J. P.; Gray, F.; Yang, J.; Boek, E. S.

    2017-06-01

    In the last decade, the study of fluid flow in porous media has developed considerably due to the combination of X-ray Micro Computed Tomography (micro-CT) and advances in computational methods for solving complex fluid flow equations directly or indirectly on reconstructed three-dimensional pore space images. In this study, we calculate porosity and single phase permeability using micro-CT imaging and Lattice Boltzmann (LB) simulations for 8 different porous media: beadpacks (with bead sizes 50 μm and 350 μm), sandpacks (LV60 and HST95), sandstones (Berea, Clashach and Doddington) and a carbonate (Ketton). Combining the observed porosity and calculated single phase permeability, we shed new light on the existence and size of the Representative Element of Volume (REV) capturing the different scales of heterogeneity from the pore-scale imaging. Our study applies the concept of the 'Convex Hull' to calculate the REV by considering the two main macroscopic petrophysical parameters, porosity and single phase permeability, simultaneously. The shape of the hull can be used to identify strong correlation between the parameters or greatly differing convergence rates. To further enhance computational efficiency we note that the area of the convex hull (for well-chosen parameters such as the log of the permeability and the porosity) decays exponentially with sub-sample size so that only a few small simulations are needed to determine the system size needed to calculate the parameters to high accuracy (small convex hull area). Finally we propose using a characteristic length such as the pore size to choose an efficient absolute voxel size for the numerical rock.

  10. Some insights for a relationship marketing model integrating SERVQUAL and customer loyalty in dental clinics

    OpenAIRE

    Vargas Perez, Ana Maria; Grijalvo Martin, Maria Mercedes; Mercado Idoeta, Carmelo

    2012-01-01

    The demand of new services, the emergence of new business models, insufficient innovation, underestimation of customer loyalty and reluctance to adopt new management are evidence of the deficiencies and the lack of research about the relations between patients and dental clinics. In this article we propose the structure of a model of Relationship Marketing (RM) in the dental clinic that integrates information from SERVQUAL, Customer Loyalty (CL) and activities of RM and combines the vision of...

  11. Preceptors' perspectives of an integrated clinical learning model in a mental health environment.

    Science.gov (United States)

    Boardman, Gayelene; Lawrence, Karen; Polacsek, Meg

    2018-02-14

    Supervised clinical practice is an essential component of undergraduate nursing students' learning and development. In the mental health setting, nursing students traditionally undertake four-week block placements. An integrated clinical learning model, where preceptors mentor students on an individual basis, has been used successfully in the clinical learning environment. This flexible model provides the opportunity for students to work across morning, afternoon, night and weekend shifts. There is a need to improve the evidence base for a flexible model for students undertaking a mental health placement. The aim of this study was to understand preceptors' experience of, and satisfaction with, a mental health integrated clinical learning model. Focus groups were used to elicit the views of preceptors from a mental health service. Findings highlight the advantages and disadvantages of an integrated clinical learning model in the mental health setting. Participants suggested that students may benefit from flexible work arrangements, a variety of experiences and a more realistic experience of working in a mental health service. However, they found it challenging to mentor and evaluate students under this model. Most also agreed that the model impeded students' ability to engage with consumers and develop rapport with staff. The findings indicate the need to develop a placement model that meets the unique needs of the mental health setting. © 2018 Australian College of Mental Health Nurses Inc.

  12. Clinical implications of in silico mathematical modeling for glioblastoma: a critical review.

    Science.gov (United States)

    Protopapa, Maria; Zygogianni, Anna; Stamatakos, Georgios S; Antypas, Christos; Armpilia, Christina; Uzunoglu, Nikolaos K; Kouloulias, Vassilis

    2018-01-01

    Glioblastoma remains a clinical challenge in spite of years of extensive research. Novel approaches are needed in order to integrate the existing knowledge. This is the potential role of mathematical oncology. This paper reviews mathematical models on glioblastoma from the clinical doctor's point of view, with focus on 3D modeling approaches of radiation response of in vivo glioblastomas based on contemporary imaging techniques. As these models aim to provide a clinically useful tool in the era of personalized medicine, the integration of the latest advances in molecular and imaging science and in clinical practice by the in silico models is crucial for their clinical relevance. Our aim is to indicate areas of GBM research that have not yet been addressed by in silico models and to point out evidence that has come up from in silico experiments, which may be worth considering in the clinic. This review examines how close these models have come in predicting the outcome of treatment protocols and in shaping the future of radiotherapy treatments.

  13. Models to enhance research capacity and capability in clinical nurses: a narrative review.

    Science.gov (United States)

    O'Byrne, Louise; Smith, Sheree

    2011-05-01

    To identify models used as local initiatives to build capability and capacity in clinical nurses. The National Health Service, Nursing and Midwifery Council and the United Kingdom Clinical Research Collaboration all support the development of the building of research capability and capacity in clinical nurses in the UK. Narrative review. A literature search of databases (including Medline and Pubmed) using the search terms nursing research, research capacity and research capability combined with building, development, model and collaboration. Publications which included a description or methodological study of a structured initiative to tackle research capacity and capability development in clinical nurses were selected. Three models were found to be dominant in the literature. These comprised evidence-based practice, facilitative and experiential learning models. Strong leadership, organisational need and support management were elements found in all three models. Methodological issues were evident and pertain to small sample sizes, inconsistent and poorly defined outcomes along with a lack of data. Whilst the vision of a research ready and active National Health Service is to be applauded to date, there appears to be limited research on the best approach to support local initiatives for nurses that build research capability and capacity. Future studies will need to focus on well-defined objectives and outcomes to enable robust evidence to support local initiatives. To build research capability and capacity in clinical nurses, there is a need to evaluate models and determine the best approach that will provide clinical nurses with research opportunities. © 2010 Blackwell Publishing Ltd.

  14. Using a finite element pediatric hip model in clinical 2 evaluation - a feasibility study

    DEFF Research Database (Denmark)

    Skytte, T. L.; Mikkelsen, Lars Pilgaard; Sonne-Holm, Stig

    2017-01-01

    The paper describe a method to construct a finite element model of the hip joint of a child based on clinical recorded CT data. A model which can be used for diagnostic aid and pre-operative surgical evaluation. First part of this development is a feasibility study of this method. A scan...... to previous published experimental studies and computational models investigating the adult hip joint. Good correlation between the current model and previous models were found. The current case specific modeling technique may be a useful complement to the previously developed hip models....

  15. Development of representative models for the study of gastric cancer and evaluation of potential antitumor agents in primary gastric cancer cells and gastric metastasis in liver

    International Nuclear Information System (INIS)

    Ortiz Chaves, Natalia

    2012-01-01

    Gastric cancer has been the sixth most common malignancy worldwide and the leading cause of death by tumors in Costa Rica, the survival of patients is limited by difficulties in diagnosis and the lack of therapeutic options to improve life expectancy. The study has conducted a number of research models that will allow in the future to better understand the pathology of this tumor and it has evaluated the therapeutic action of naturally occurring in gastric cancer cells. A vivo model of carcinogenesis in stomachs of Wistar rats, has achieved to establish by means of chemical induction with MNNG, in which it has been possible to observe the appearance of tumors in the stratified epithelium flat keratinized starting from week 22 of experiment; while for the 40th week adenomas were observed in the simple cylindrical epithelium. Additionally, the role of Helicobacter pylori was inquired in the development of gastric cancer by inoculation of two strains of bacteria (CagA + and CagA-) in the stomach of Wistar rats, as well as the effect of his administration together with MNNG. However, the results of these models have been limited due to the lack of detection of the bacteria in the stomachs of rats inoculated. In addition, it has established an in vitro model of threedimensional cell culture, which has allowed to reproduce some of the characteristics observed in vivo in the tumors, in this case it was determined that the two gastric cancer cell lines have showed a different behavior, since the cells NCI-N87 from a in metastasis gastric liver were able to form steroids compact whereas AGS cells have been originate from a primary tumor that has formed easily dispersible structures and not compact spheroids. Finally, the effect of natural retinoids ATRA and retinoic acid 13-cis were evaluated, as well as retinamide synthetic retinoid on the viability of the cells AGS and NCI-N87. Cytotoxicity assays using MTT have allowed to observe the reduction of a variation in the

  16. NUMERICAL MODELING OF THE DISRUPTION OF COMET D/1993 F2 SHOEMAKER-LEVY 9 REPRESENTING THE PROGENITOR BY A GRAVITATIONALLY BOUND ASSEMBLAGE OF RANDOMLY SHAPED POLYHEDRA

    Energy Technology Data Exchange (ETDEWEB)

    Movshovitz, Naor; Asphaug, Erik; Korycansky, Donald, E-mail: nmovshov@ucsc.edu [Department of Earth and Planetary Sciences, University of California, Santa Cruz, 1156 High Street, Santa Cruz, CA 95064 (United States)

    2012-11-10

    We advance the modeling of rubble-pile solid bodies by re-examining the tidal breakup of comet Shoemaker-Levy 9, an event that occurred during a 1.33 R encounter with Jupiter in 1992 July. Tidal disruption of the comet nucleus led to a chain of sub-nuclei {approx}100-1000 m diameter; these went on to collide with the planet two years later. They were intensively studied prior to and during the collisions, making SL9 the best natural benchmark for physical models of small-body disruption. For the first time in the study of this event, we use numerical codes treating rubble piles as collections of polyhedra. This introduces forces of dilatation and friction, and inelastic response. As in our previous studies we conclude that the progenitor must have been a rubble pile, and we obtain approximately the same pre-breakup diameter ({approx}1.5 km) in our best fits to the data. We find that the inclusion of realistic fragment shapes leads to grain locking and dilatancy, so that even in the absence of friction or other dissipation we find that disruption is overall more difficult than in our spheres-based simulations. We constrain the comet's bulk density at {rho}{sub bulk} {approx} 300-400 kg m{sup -3}, half that of our spheres-based predictions and consistent with recent estimates derived from spacecraft observations.

  17. Code assessment and modelling for Design Basis Accident analysis of the European Sodium Fast Reactor design. Part II: Optimised core and representative transients analysis

    Energy Technology Data Exchange (ETDEWEB)

    Lazaro, A., E-mail: aulach@iqn.upv.es [JRC-IET European Commission, Westerduinweg 3, PO BOX 2, 1755 ZG Petten (Netherlands); Schikorr, M. [KIT, Institute for Neutron Physics and Reactor Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen (Germany); Mikityuk, K. [PSI, Paul Scherrer Institut, 5232 Villigen (Switzerland); Ammirabile, L. [JRC-IET European Commission, Westerduinweg 3, PO BOX 2, 1755 ZG Petten (Netherlands); Bandini, G. [ENEA, Via Martiri di Monte Sole 4, 40129 Bologna (Italy); Darmet, G.; Schmitt, D. [EDF, 1 Avenue du Général de Gaulle, 92141 Clamart (France); Dufour, Ph.; Tosello, A. [CEA, St. Paul lez Durance, 13108 Cadarache (France); Gallego, E.; Jimenez, G. [UPM, José Gutiérrez Abascal, 2, 28006 Madrid (Spain); Bubelis, E.; Ponomarev, A.; Kruessmann, R.; Struwe, D. [KIT, Institute for Neutron Physics and Reactor Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen (Germany); Stempniewicz, M. [NRG, Utrechtseweg 310, P.O. Box-9034, 6800 ES Arnhem (Netherlands)

    2014-10-01

    Highlights: • Benchmarked models have been applied for the analysis of DBA transients of the ESFR design. • Two system codes are able to simulate the behavior of the system beyond sodium boiling. • The optimization of the core design and its influence in the transients’ evolution is described. • The analysis has identified peak values and grace times for the protection system design. - Abstract: The new reactor concepts proposed in the Generation IV International Forum require the development and validation of computational tools able to assess their safety performance. In the first part of this paper the models of the ESFR design developed by several organisations in the framework of the CP-ESFR project were presented and their reliability validated via a benchmarking exercise. This second part of the paper includes the application of those tools for the analysis of design basis accident (DBC) scenarios of the reference design. Further, this paper also introduces the main features of the core optimisation process carried out within the project with the objective to enhance the core safety performance through the reduction of the positive coolant density reactivity effect. The influence of this optimised core design on the reactor safety performance during the previously analysed transients is also discussed. The conclusion provides an overview of the work performed by the partners involved in the project towards the development and enhancement of computational tools specifically tailored to the evaluation of the safety performance of the Generation IV innovative nuclear reactor designs.

  18. Code assessment and modelling for Design Basis Accident analysis of the European Sodium Fast Reactor design. Part II: Optimised core and representative transients analysis

    International Nuclear Information System (INIS)

    Lazaro, A.; Schikorr, M.; Mikityuk, K.; Ammirabile, L.; Bandini, G.; Darmet, G.; Schmitt, D.; Dufour, Ph.; Tosello, A.; Gallego, E.; Jimenez, G.; Bubelis, E.; Ponomarev, A.; Kruessmann, R.; Struwe, D.; Stempniewicz, M.

    2014-01-01

    Highlights: • Benchmarked models have been applied for the analysis of DBA transients of the ESFR design. • Two system codes are able to simulate the behavior of the system beyond sodium boiling. • The optimization of the core design and its influence in the transients’ evolution is described. • The analysis has identified peak values and grace times for the protection system design. - Abstract: The new reactor concepts proposed in the Generation IV International Forum require the development and validation of computational tools able to assess their safety performance. In the first part of this paper the models of the ESFR design developed by several organisations in the framework of the CP-ESFR project were presented and their reliability validated via a benchmarking exercise. This second part of the paper includes the application of those tools for the analysis of design basis accident (DBC) scenarios of the reference design. Further, this paper also introduces the main features of the core optimisation process carried out within the project with the objective to enhance the core safety performance through the reduction of the positive coolant density reactivity effect. The influence of this optimised core design on the reactor safety performance during the previously analysed transients is also discussed. The conclusion provides an overview of the work performed by the partners involved in the project towards the development and enhancement of computational tools specifically tailored to the evaluation of the safety performance of the Generation IV innovative nuclear reactor designs

  19. [Structural Equation Modeling of Quality of Work Life in Clinical Nurses based on the Culture-Work-Health Model].

    Science.gov (United States)

    Kim, Miji; Ryu, Eunjung

    2015-12-01

    The purpose of this study was to construct and test a structural equation model of quality of work life for clinical nurses based on Peterson and Wilson's Culture-Work-Health model (CWHM). A structured questionnaire was completed by 523 clinical nurses to analyze the relationships between concepts of CWHM-organizational culture, social support, employee health, organizational health, and quality of work life. Among these conceptual variables of CWHM, employee health was measured by perceived health status, and organizational health was measured by presenteeism. SPSS21.0 and AMOS 21.0 programs were used to analyze the efficiency of the hypothesized model and calculate the direct and indirect effects of factors affecting quality of work life among clinical nurses. The goodness-of-fit statistics of the final modified hypothetical model are as follows: χ²=586.03, χ²/df=4.19, GFI=.89, AGFI=.85, CFI=.91, TLI=.90, NFI=.89, and RMSEA=.08. The results revealed that organizational culture, social support, organizational health, and employee health accounted for 69% of clinical nurses' quality of work life. The major findings of this study indicate that it is essential to create a positive organizational culture and provide adequate organizational support to maintain a balance between the health of clinical nurses and the organization. Further repeated and expanded studies are needed to explore the multidimensional aspects of clinical nurses' quality of work life in Korea, including various factors, such as work environment, work stress, and burnout.

  20. Nursing students' perceptions of a collaborative clinical placement model: A qualitative descriptive study.

    Science.gov (United States)

    van der Riet, Pamela; Levett-Jones, Tracy; Courtney-Pratt, Helen

    2018-03-01

    Clinical placements are specifically designed to facilitate authentic learning opportunities and are an integral component of undergraduate nursing programs. However, as academics and clinicians frequently point out, clinical placements are fraught with problems that are long-standing and multidimensional in nature. Collaborative placement models, grounded in a tripartite relationship between students, university staff and clinical partners, and designed to foster students' sense of belonging, have recently been implemented to address many of the challenges associated with clinical placements. In this study a qualitative descriptive design was undertaken with the aim of exploring 14 third year third year nursing students' perceptions of a collaborative clinical placement model undertaken in an Australian university. Students participated in audio recorded focus groups following their final clinical placement. Thematic analysis of the interview data resulted in identification of six main themes: Convenience and Camaraderie, Familiarity and Confidence, Welcomed and Wanted, Belongingness and Support, Employment, and The Need for Broader Clinical Experiences. The clinical collaborative model fostered a sense of familiarity for many of the participants and this led to belongingness, acceptance, confidence and meaningful learning experiences. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. Model for teaching population health and community-based care across diverse clinical experiences.

    Science.gov (United States)

    Van Dyk, Elizabeth J; Valentine-Maher, Sarah K; Tracy, Janet P

    2015-02-01

    The pillars constructivist model is designed to offer a unifying clinical paradigm to support consistent learning opportunities across diverse configurations of community and public health clinical sites. Thirty-six students and six faculty members participated in a mixed methods evaluation to assess the model after its inaugural semester of implementation. The evaluation methods included a rating scale that measures the model's ability to provide consistent learning opportunities at both population health and direct care sites, a case study to measure student growth within the five conceptual pillars, and a faculty focus group. Results revealed that the model served as an effective means of clinical education to support the use of multiple, small-scale public health sites. Although measurements of student growth within the pillars are inconclusive, the findings suggest efficacy. The authors recommend the continued use of the pillars constructivist model in baccalaureate programs, with further study of the author-designed evaluation tools. Copyright 2015, SLACK Incorporated.

  2. Comparsion analysis of data mining models applied to clinical research in traditional Chinese medicine.

    Science.gov (United States)

    Zhao, Yufeng; Xie, Qi; He, Liyun; Liu, Baoyan; Li, Kun; Zhang, Xiang; Bai, Wenjing; Luo, Lin; Jing, Xianghong; Huo, Ruili

    2014-10-01

    To help researchers selecting appropriate data mining models to provide better evidence for the clinical practice of Traditional Chinese Medicine (TCM) diagnosis and therapy. Clinical issues based on data mining models were comprehensively summarized from four significant elements of the clinical studies: symptoms, symptom patterns, herbs, and efficacy. Existing problems were further generalized to determine the relevant factors of the performance of data mining models, e.g. data type, samples, parameters, variable labels. Combining these relevant factors, the TCM clinical data features were compared with regards to statistical characters and informatics properties. Data models were compared simultaneously from the view of applied conditions and suitable scopes. The main application problems were the inconsistent data type and the small samples for the used data mining models, which caused the inappropriate results, even the mistake results. These features, i.e. advantages, disadvantages, satisfied data types, tasks of data mining, and the TCM issues, were summarized and compared. By aiming at the special features of different data mining models, the clinical doctors could select the suitable data mining models to resolve the TCM problem.

  3. Anti-VEGF therapy in the management of retinopathy of prematurity: what we learn from representative animal models of oxygen-induced retinopathy

    Directory of Open Access Journals (Sweden)

    Wang H

    2016-05-01

    Full Text Available Haibo Wang Department of Ophthalmology, John A Moran Eye Center, The University of Utah, Salt Lake City, UT, USA Abstract: Retinopathy of prematurity (ROP remains a leading cause of childhood blindness, affecting infants born prematurely. ROP is characterized by the onset of delayed physiological retinal vascular development (PRVD and followed by pathologic neovascularization into the vitreous instead of the retina, called intravitreal neovascularization (IVNV. Therefore, the therapeutic strategy for treating ROP is to promote PRVD and inhibit or prevent IVNV. Vascular endothelial growth factor (VEGF plays an important role in the pathogenesis of ROP. There is a growing body of studies testing the use of anti-VEGF agents as a treatment for ROP. Intravitreal anti-VEGF treatment for ROP has potential advantages compared with laser photocoagulation, the gold standard for the treatment of severe ROP; however, intravitreal anti-VEGF treatment has been associated with reactivation of ROP and suppression of systemic VEGF that may affect body growth and organ development in preterm infants. Therefore, it is important to understand the role of VEGF in PRVD and IVNV. This review includes the current knowledge of anti-VEGF treatment for ROP from animal models of oxygen-induced retinopathy (OIR, highlighting the importance of VEGF inhibition by targeting retinal Müller cells, which inhibits IVNV and permits PRVD. The signaling events involved in mediating VEGF expression and promoting VEGF-mediated angiogenesis, including hypoxia-dependent signaling, erythropoietin/erythropoietin receptor-, oxidative stress-, beta-adrenergic receptor-, integrin-, Notch/Delta-like ligand 4- and exon guidance molecules-mediated signaling pathways, are also discussed. Keywords: vascular endothelial growth factor, retinopathy of prematurity, intravitreal neovascularization, oxygen-induced retinopathy model, physiological retinal vascular development

  4. Creation of a 3D printed temporal bone model from clinical CT data.

    Science.gov (United States)

    Cohen, Joss; Reyes, Samuel A

    2015-01-01

    Generate and describe the process of creating a 3D printed, rapid prototype temporal bone model from clinical quality CT images. We describe a technique to create an accurate, alterable, and reproducible rapid prototype temporal bone model using freely available software to segment clinical CT data and generate three different 3D models composed of ABS plastic. Each model was evaluated based on the appearance and size of anatomical structures and response to surgical drilling. Mastoid air cells had retained scaffolding material in the initial versions. This required modifying the model to allow drainage of the scaffolding material. External auditory canal dimensions were similar to those measured from the clinical data. Malleus, incus, oval window, round window, promontory, horizontal semicircular canal, and mastoid segment of the facial nerve canal were identified in all models. The stapes was only partially formed in two models and absent in the third. Qualitative feel of the ABS plastic was softer than bone. The pate produced by drilling was similar to bone dust when appropriate irrigation was used. We present a rapid prototype temporal bone model made based on clinical CT data using 3D printing technology. The model can be made quickly and inexpensively enough to have potential applications for educational training. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Clinical challenges of chronic wounds: searching for an optimal animal model to recapitulate their complexity

    Directory of Open Access Journals (Sweden)

    Robert Nunan

    2014-11-01

    Full Text Available The efficient healing of a skin wound is something that most of us take for granted but is essential for surviving day-to-day knocks and cuts, and is absolutely relied on clinically whenever a patient receives surgical intervention. However, the management of a chronic wound – defined as a barrier defect that has not healed in 3 months – has become a major therapeutic challenge throughout the Western world, and it is a problem that will only escalate with the increasing incidence of conditions that impede wound healing, such as diabetes, obesity and vascular disorders. Despite being clinically and molecularly heterogeneous, all chronic wounds are generally assigned to one of three major clinical categories: leg ulcers, diabetic foot ulcers or pressure ulcers. Although we have gleaned much knowledge about the fundamental cellular and molecular mechanisms that underpin healthy, acute wound healing from various animal models, we have learned much less about chronic wound repair pathology from these models. This might largely be because the animal models being used in this field of research have failed to recapitulate the clinical features of chronic wounds. In this Clinical Puzzle article, we discuss the clinical complexity of chronic wounds and describe the best currently available models for investigating chronic wound pathology. We also assess how such models could be optimised to become more useful tools for uncovering pathological mechanisms and potential therapeutic treatments.

  6. Disease Progression/Clinical Outcome Model for Castration-Resistant Prostate Cancer in Patients Treated with Eribulin

    NARCIS (Netherlands)

    Van Hasselt, J. G C; Gupta, A.; Hussein, Z.; Beijnen, J. H.; Schellens, J. H M; Huitema, A. D R

    2015-01-01

    Frameworks that associate cancer dynamic disease progression models with parametric survival models for clinical outcome have recently been proposed to support decision making in early clinical development. Here we developed such a disease progression clinical outcome model for castration-resistant

  7. Anti-VEGF therapy in the management of retinopathy of prematurity: what we learn from representative animal models of oxygen-induced retinopathy.

    Science.gov (United States)

    Wang, Haibo

    2016-01-01

    Retinopathy of prematurity (ROP) remains a leading cause of childhood blindness, affecting infants born prematurely. ROP is characterized by the onset of delayed physiological retinal vascular development (PRVD) and followed by pathologic neovascularization into the vitreous instead of the retina, called intravitreal neovascularization (IVNV). Therefore, the therapeutic strategy for treating ROP is to promote PRVD and inhibit or prevent IVNV. Vascular endothelial growth factor (VEGF) plays an important role in the pathogenesis of ROP. There is a growing body of studies testing the use of anti-VEGF agents as a treatment for ROP. Intravitreal anti-VEGF treatment for ROP has potential advantages compared with laser photocoagulation, the gold standard for the treatment of severe ROP; however, intravitreal anti-VEGF treatment has been associated with reactivation of ROP and suppression of systemic VEGF that may affect body growth and organ development in preterm infants. Therefore, it is important to understand the role of VEGF in PRVD and IVNV. This review includes the current knowledge of anti-VEGF treatment for ROP from animal models of oxygen-induced retinopathy (OIR), highlighting the importance of VEGF inhibition by targeting retinal Müller cells, which inhibits IVNV and permits PRVD. The signaling events involved in mediating VEGF expression and promoting VEGF-mediated angiogenesis, including hypoxia-dependent signaling, erythropoietin/erythropoietin receptor-, oxidative stress-, beta-adrenergic receptor-, integrin-, Notch/Delta-like ligand 4- and exon guidance molecules-mediated signaling pathways, are also discussed.

  8. Representing Uncertainty by Probability and Possibility

    DEFF Research Database (Denmark)

    of uncertain parameters. Monte Carlo simulation is readily used for practical calculations. However, an alternative approach is offered by possibility theory making use of possibility distributions such as intervals and fuzzy intervals. This approach is well suited to represent lack of knowledge or imprecision......Uncertain parameters in modeling are usually represented by probability distributions reflecting either the objective uncertainty of the parameters or the subjective belief held by the model builder. This approach is particularly suited for representing the statistical nature or variance...

  9. A new in situ model to study erosive enamel wear, a clinical pilot study.

    NARCIS (Netherlands)

    Ruben, J.L.; Truin, G.J.; Bronkhorst, E.M.; Huysmans, M.C.D.N.J.M.

    2017-01-01

    OBJECTIVES: To develop an in situ model for erosive wear research which allows for more clinically relevant exposure parameters than other in situ models and to show tooth site-specific erosive wear effect of an acid challenge of orange juice on enamel. METHODS: This pilot study included 6

  10. Sustainability of the integrated chronic disease management model at primary care clinics in South Africa

    Directory of Open Access Journals (Sweden)

    Ozayr H. Mahomed

    2016-11-01

    Conclusion: The less than optimal involvement of clinical leadership (doctors, negative staff behaviour towards the ICDM, adaptability or flexibility of the model to adapt to external factors and infrastructure limitation have the potential to negatively affect the sustainability and scale-up of the model.

  11. Disease models of chronic inflammatory airway disease : applications and requirements for clinical trials

    NARCIS (Netherlands)

    Diamant, Zuzana; Clarke, Graham W.; Pieterse, Herman; Gispert, Juan

    Purpose of reviewThis review will discuss methodologies and applicability of key inflammatory models of respiratory disease in proof of concept or proof of efficacy clinical studies. In close relationship with these models, induced sputum and inflammatory cell counts will be addressed for

  12. Comparison of RNA-seq and microarray-based models for clinical endpoint prediction.

    Science.gov (United States)

    Zhang, Wenqian; Yu, Ying; Hertwig, Falk; Thierry-Mieg, Jean; Zhang, Wenwei; Thierry-Mieg, Danielle; Wang, Jian; Furlanello, Cesare; Devanarayan, Viswanath; Cheng, Jie; Deng, Youping; Hero, Barbara; Hong, Huixiao; Jia, Meiwen; Li, Li; Lin, Simon M; Nikolsky, Yuri; Oberthuer, André; Qing, Tao; Su, Zhenqiang; Volland, Ruth; Wang, Charles; Wang, May D; Ai, Junmei; Albanese, Davide; Asgharzadeh, Shahab; Avigad, Smadar; Bao, Wenjun; Bessarabova, Marina; Brilliant, Murray H; Brors, Benedikt; Chierici, Marco; Chu, Tzu-Ming; Zhang, Jibin; Grundy, Richard G; He, Min Max; Hebbring, Scott; Kaufman, Howard L; Lababidi, Samir; Lancashire, Lee J; Li, Yan; Lu, Xin X; Luo, Heng; Ma, Xiwen; Ning, Baitang; Noguera, Rosa; Peifer, Martin; Phan, John H; Roels, Frederik; Rosswog, Carolina; Shao, Susan; Shen, Jie; Theissen, Jessica; Tonini, Gian Paolo; Vandesompele, Jo; Wu, Po-Yen; Xiao, Wenzhong; Xu, Joshua; Xu, Weihong; Xuan, Jiekun; Yang, Yong; Ye, Zhan; Dong, Zirui; Zhang, Ke K; Yin, Ye; Zhao, Chen; Zheng, Yuanting; Wolfinger, Russell D; Shi, Tieliu; Malkas, Linda H; Berthold, Frank; Wang, Jun; Tong, Weida; Shi, Leming; Peng, Zhiyu; Fischer, Matthias

    2015-06-25

    Gene expression profiling is being widely applied in cancer research to identify biomarkers for clinical endpoint prediction. Since RNA-seq provides a powerful tool for transcriptome-based applications beyond the limitations of microarrays, we sought to systematically evaluate the performance of RNA-seq-based and microarray-based classifiers in this MAQC-III/SEQC study for clinical endpoint prediction using neuroblastoma as a model. We generate gene expression profiles from 498 primary neuroblastomas using both RNA-seq and 44 k microarrays. Characterization of the neuroblastoma transcriptome by RNA-seq reveals that more than 48,000 genes and 200,000 transcripts are being expressed in this malignancy. We also find that RNA-seq provides much more detailed information on specific transcript expression patterns in clinico-genetic neuroblastoma subgroups than microarrays. To systematically compare the power of RNA-seq and microarray-based models in predicting clinical endpoints, we divide the cohort randomly into training and validation sets and develop 360 predictive models on six clinical endpoints of varying predictability. Evaluation of factors potentially affecting model performances reveals that prediction accuracies are most strongly influenced by the nature of the clinical endpoint, whereas technological platforms (RNA-seq vs. microarrays), RNA-seq data analysis pipelines, and feature levels (gene vs. transcript vs. exon-junction level) do not significantly affect performances of the models. We demonstrate that RNA-seq outperforms microarrays in determining the transcriptomic characteristics of cancer, while RNA-seq and microarray-based models perform similarly in clinical endpoint prediction. Our findings may be valuable to guide future studies on the development of gene expression-based predictive models and their implementation in clinical practice.

  13. An immunologic model for rapid vaccine assessment -- a clinical trial in a test tube.

    Science.gov (United States)

    Higbee, Russell G; Byers, Anthony M; Dhir, Vipra; Drake, Donald; Fahlenkamp, Heather G; Gangur, Jyoti; Kachurin, Anatoly; Kachurina, Olga; Leistritz, Del; Ma, Yifan; Mehta, Riyaz; Mishkin, Eric; Moser, Janice; Mosquera, Luis; Nguyen, Mike; Parkhill, Robert; Pawar, Santosh; Poisson, Louis; Sanchez-Schmitz, Guzman; Schanen, Brian; Singh, Inderpal; Song, Haifeng; Tapia, Tenekua; Warren, William; Wittman, Vaughan

    2009-09-01

    While the duration and size of human clinical trials may be difficult to reduce, there are several parameters in pre-clinical vaccine development that may be possible to further optimise. By increasing the accuracy of the models used for pre-clinical vaccine testing, it should be possible to increase the probability that any particular vaccine candidate will be successful in human trials. In addition, an improved model will allow the collection of increasingly more-informative data in pre-clinical tests, thus aiding the rational design and formulation of candidates entered into clinical evaluation. An acceleration and increase in sophistication of pre-clinical vaccine development will thus require the advent of more physiologically-accurate models of the human immune system, coupled with substantial advances in the mechanistic understanding of vaccine efficacy, achieved by using this model. We believe the best viable option available is to use human cells and/or tissues in a functional in vitro model of human physiology. Not only will this more accurately model human diseases, it will also eliminate any ethical, moral and scientific issues involved with use of live humans and animals. An in vitro model, termed "MIMIC" (Modular IMmune In vitro Construct), was designed and developed to reflect the human immune system in a well-based format. The MIMIC System is a laboratory-based methodology that replicates the human immune system response. It is highly automated, and can be used to simulate a clinical trial for a diverse population, without putting human subjects at risk. The MIMIC System uses the circulating immune cells of individual donors to recapitulate each individual human immune response by maintaining the autonomy of the donor. Thus, an in vitro test system has been created that is functionally equivalent to the donor's own immune system and is designed to respond in a similar manner to the in vivo response. 2009 FRAME.

  14. Canadian Chronic Kidney Disease Clinics: A National Survey of Structure, Function and Models of Care

    Directory of Open Access Journals (Sweden)

    Adeera Levin

    2014-11-01

    Full Text Available Background: The goals of care for patients with chronic kidney disease (CKD are to delay progression to end stage renal disease, reduce complications, and to ensure timely transition to dialysis or transplantation, while optimizing independence. Recent guidelines recommend that multidisciplinary team based care should be available to patients with CKD. While most provinces fund CKD care, the specific models by which these outcomes are achieved are not known. Funding for clinics is hospital or program based. Objectives: To describe the structure and function of clinics in order to understand the current models of care, inform best practice and potentially standardize models of care. Design: Prospective cross sectional observational survey study. Setting, Patients/Participants: Canadian nephrology programs in all provinces. Methods and Measurements: Using an open-ended semi-structured questionnaire, we surveyed 71 of 84 multidisciplinary adult CKD clinics across Canada, by telephone and with written semi-structured questionnaires; (June 2012 to November 2013. Standardized introductory scripts were used, in both English and French. Results: CKD clinic structure and models of care vary significantly across Canada. Large variation exists in staffing ratios (Nephrologist, dieticians, pharmacists and nurses to patients, and in referral criteria. Dialysis initiation decisions were usually made by MDs. The majority of clinics (57% had a consistent model of care (the same Nephrologist and nurse per patient, while others had patients seeing a different nephrologist and nurses at each clinic visit. Targets for various modality choices varied, as did access to those modalities. No patient or provider educational tools describing the optimal time to start dialysis exist in any of the clinics. Limitations: The surveys rely on self reporting without validation from independent sources, and there was limited involvement of Quebec clinics. These are relative

  15. Estimating representative background PM2.5 concentration in heavily polluted areas using baseline separation technique and chemical mass balance model

    Science.gov (United States)

    Gao, Shuang; Yang, Wen; Zhang, Hui; Sun, Yanling; Mao, Jian; Ma, Zhenxing; Cong, Zhiyuan; Zhang, Xian; Tian, Shasha; Azzi, Merched; Chen, Li; Bai, Zhipeng

    2018-02-01

    The determination of background concentration of PM2.5 is important to understand the contribution of local emission sources to total PM2.5 concentration. The purpose of this study was to exam the performance of baseline separation techniques to estimate PM2.5 background concentration. Five separation methods, which included recursive digital filters (Lyne-Hollick, one-parameter algorithm, and Boughton two-parameter algorithm), sliding interval and smoothed minima, were applied to one-year PM2.5 time-series data in two heavily polluted cities, Tianjin and Jinan. To obtain the proper filter parameters and recession constants for the separation techniques, we conducted regression analysis at a background site during the emission reduction period enforced by the Government for the 2014 Asia-Pacific Economic Cooperation (APEC) meeting in Beijing. Background concentrations in Tianjin and Jinan were then estimated by applying the determined filter parameters and recession constants. The chemical mass balance (CMB) model was also applied to ascertain the effectiveness of the new approach. Our results showed that the contribution of background PM concentration to ambient pollution was at a comparable level to the contribution obtained from the previous study. The best performance was achieved using the Boughton two-parameter algorithm. The background concentrations were estimated at (27 ± 2) μg/m3 for the whole year, (34 ± 4) μg/m3 for the heating period (winter), (21 ± 2) μg/m3 for the non-heating period (summer), and (25 ± 2) μg/m3 for the sandstorm period in Tianjin. The corresponding values in Jinan were (30 ± 3) μg/m3, (40 ± 4) μg/m3, (24 ± 5) μg/m3, and (26 ± 2) μg/m3, respectively. The study revealed that these baseline separation techniques are valid for estimating levels of PM2.5 air pollution, and that our proposed method has great potential for estimating the background level of other air pollutants.

  16. Critical thinking in clinical nurse education: application of Paul's model of critical thinking.

    Science.gov (United States)

    Andrea Sullivan, E

    2012-11-01

    Nurse educators recognize that many nursing students have difficulty in making decisions in clinical practice. The ability to make effective, informed decisions in clinical practice requires that nursing students know and apply the processes of critical thinking. Critical thinking is a skill that develops over time and requires the conscious application of this process. There are a number of models in the nursing literature to assist students in the critical thinking process; however, these models tend to focus solely on decision making in hospital settings and are often complex to actualize. In this paper, Paul's Model of Critical Thinking is examined for its application to nursing education. I will demonstrate how the model can be used by clinical nurse educators to assist students to develop critical thinking skills in all health care settings in a way that makes critical thinking skills accessible to students. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Thinking like a nurse: a research-based model of clinical judgment in nursing.

    Science.gov (United States)

    Tanner, Christine A

    2006-06-01

    This article reviews the growing body of research on clinical judgment in nursing and presents an alternative model of clinical judgment based on these studies. Based on a review of nearly 200 studies, five conclusions can be drawn: (1) Clinical judgments are more influenced by what nurses bring to the situation than the objective data about the situation at hand; (2) Sound clinical judgment rests to some degree on knowing the patient and his or her typical pattern of responses, as well as an engagement with the patient and his or her concerns; (3) Clinical judgments are influenced by the context in which the situation occurs and the culture of the nursing care unit; (4) Nurses use a variety of reasoning patterns alone or in combination; and (5) Reflection on practice is often triggered by a breakdown in clinical judgment and is critical for the development of clinical knowledge and improvement in clinical reasoning. A model based on these general conclusions emphasizes the role of nurses' background, the context of the situation, and nurses' relationship with their patients as central to what nurses notice and how they interpret findings, respond, and reflect on their response.

  18. A model to begin to use clinical outcomes in medical education.

    Science.gov (United States)

    Haan, Constance K; Edwards, Fred H; Poole, Betty; Godley, Melissa; Genuardi, Frank J; Zenni, Elisa A

    2008-06-01

    The latest phase of the Accreditation Council for Graduate Medical Education (ACGME) Outcome Project challenges graduate medical education (GME) programs to select meaningful clinical quality indicators by which to measure trainee performance and progress, as well as to assess and improve educational effectiveness of programs. The authors describe efforts to measure educational quality, incorporating measurable patient-care outcomes to guide improvement. University of Florida College of Medicine-Jacksonville education leaders developed a tiered framework for selecting clinical indicators whose outcomes would illustrate integration of the ACGME competencies and their assessment with learning and clinical care. In order of preference, indicators selected should align with a specialty's (1) national benchmarked consensus standards, (2) national specialty society standards, (3) standards of local, institutional, or regional quality initiatives, or (4) top-priority diagnostic and/or therapeutic categories for the specialty, based on areas of high frequency, impact, or cost. All programs successfully applied the tiered process to clinical indicator selection and then identified data sources to track clinical outcomes. Using clinical outcomes in resident evaluation assesses the resident's performance as reflective of his or her participation in the health care delivery team. Programmatic improvements are driven by clinical outcomes that are shown to be below benchmark across the residents. Selecting appropriate clinical indicators-representative of quality of care and of graduate medical education-is the first step toward tracking educational outcomes using clinical data as the basis for evaluation and improvement. This effort is an important aspect of orienting trainees to using data for monitoring and improving care processes and outcomes throughout their careers.

  19. Sustainability of the integrated chronic disease management model at primary care clinics in South Africa

    Science.gov (United States)

    Asmall, Shaidah

    2016-01-01

    Background An integrated chronic disease management (ICDM) model consisting of four components (facility reorganisation, clinical supportive management, assisted self-supportive management and strengthening of support systems and structures outside the facility) has been implemented across 42 primary health care clinics in South Africa with a view to improve the operational efficiency and patient clinical outcomes. Aim The aim of this study was to assess the sustainability of the facility reorganisation and clinical support components 18 months after the initiation. Setting The study was conducted at 37 of the initiating clinics across three districts in three provinces of South Africa. Methods The National Health Service (NHS) Institute for Innovation and Improvement Sustainability Model (SM) self-assessment tool was used to assess sustainability. Results Bushbuckridge had the highest mean sustainability score of 71.79 (95% CI: 63.70–79.89) followed by West Rand Health District (70.25 (95% CI: 63.96–76.53)) and Dr Kenneth Kaunda District (66.50 (95% CI: 55.17–77.83)). Four facilities (11%) had an overall sustainability score of less than 55. Conclusion The less than optimal involvement of clinical leadership (doctors), negative staff behaviour towards the ICDM, adaptability or flexibility of the model to adapt to external factors and infrastructure limitation have the potential to negatively affect the sustainability and scale-up of the model. PMID:28155314

  20. Use of representative models in the decision making process of an offshore field development plan; Utilizacao de modelos representativos na tomada de de